Unusual Content Research Articles

The unnatural acoustic space of Das Haus: A ‘three-dimensional’ radio play adaptation of Mark Z. Danielewski’s House of Leaves

Despite its status as a cult novel, adaptations of Mark Z. Danielewski’s House of Leaves (2000) have been rare. This is not surprising, considering that the book’s unusual form is intrinsically connected to its equally unusual content. The novel’s story concerns a film about a house whose dimensions defy the laws of physics. The novel continually highlights the impossibility of its own filmic adaptation. Many of the main characters underline that the film medium inherently falls short of representing the unnatural space that is at the heart of the story. One successful adaptation is Das Haus (2010), a German radio play version of the novel that presents the story of House of Leaves in three different productions that were broadcast on three stations simultaneously. Listeners were invited to switch between the channels to find their own way through the story. This article focuses on the topic of space as it relates to sound in both the novel and the radio play adaptation, demonstrating how Das Haus relies on medium-specific elements to represent the unnatural narrative space of the story.

Preambulum az idegenjogi szakigazgatás rendszerében

Aim: The aim of this paper is to present - in addition to the preambles of the legislation on alien policy from 1903 to the present day - the preamble of Act XC of 2023 on the General Rules for the Entry and Residence of Third-Country Nationals. Methodology: This study considers the practice of the specifications of the preambles of the legislations on the entry and residence of foreigners, and compares, according to grammatical and logical criteria, the certain sentences of the introductory text of Act XC of 2023 on the General Rules for the Entry and Residence of Third-Country Nationals with the normative provisions of this Act and other legislations, in particular the Fundamental Law of Hungary. Findings: The preamble of Act XC of 2023 on the General Rules for the Entry and Residence of Third-Country Nationals introduces the normative provisions of the Act with an unusual content compared to the legislation so far. This content cannot, however, be examined in isolation, but only in the light of the specific legal provisions (constitutional, statutory, regulatory) establishing rights and obligations. Value: The value of the study is to draw attention to the fact that in the system of legislation, only the specific provisions of individual pieces of legislation have normative force, and that the texts and preambles introducing individual pieces of legislation can contribute to the interpretation of these legislative provisions.

Pathogen-specific structural features of Candida albicans Ras1 activation complex: uncovering new antifungal drug targets.

An important feature associated with Candida albicans pathogenicity is its ability to switch between yeast and hyphal forms, a process in which CaRas1 plays a key role. CaRas1 is activated by the guanine nucleotide exchange factor (GEF) CaCdc25, triggering hyphal growth-related signaling pathways through its conserved GTP-binding (G)-domain. An important function in hyphal growth has also been proposed for the long hypervariable region downstream the G-domain, whose unusual content of polyglutamine stretches and Q/N repeats make CaRas1 unique within Ras proteins. Despite its biological importance, both the structure of CaRas1 and the molecular basis of its activation by CaCdc25 remain unexplored. Here, we show that CaRas1 has an elongated shape and limited conformational flexibility and that its hypervariable region contains helical structural elements, likely forming an intramolecular coiled-coil. Functional assays disclosed that CaRas1-activation by CaCdc25 is highly efficient, with activities up to 2,000-fold higher than reported for human GEFs. The crystal structure of the CaCdc25 catalytic region revealed an active conformation for the α-helical hairpin, critical for CaRas1-activation, unveiling a specific region exclusive to CTG-clade species. Structural studies on CaRas1/CaCdc25 complexes also revealed an interaction surface clearly distinct from that of homologous human complexes. Furthermore, we identified an inhibitory synthetic peptide, prompting the proposal of a key regulatory mechanism for CaCdc25. To our knowledge, this is the first report of specific inhibition of the CaRas1-activation via targeting its GEF. This, together with their unique pathogen-structural features, disclose a set of novel strategies to specifically block this important virulence-related mechanism. IMPORTANCE Candida albicans is the main causative agent of candidiasis, the commonest fungal infection in humans. The eukaryotic nature of C. albicans and the rapid emergence of antifungal resistance raise the challenge of identifying novel drug targets to battle this prevalent and life-threatening disease. CaRas1 and CaCdc25 are key players in the activation of signaling pathways triggering multiple virulence traits, including the yeast-to-hypha interconversion. The structural similarity of the conserved G-domain of CaRas1 to those of human homologs and the lack of structural information on CaCdc25 has impeded progress in targeting these proteins. The unique structural and functional features for CaRas1 and CaCdc25 presented here, together with the identification of a synthetic peptide capable of specifically inhibiting the GEF activity of CaCdc25, open new possibilities to uncover new antifungal drug targets against C. albicans virulence.

A Compendium of Official Correspondence from Seleucid Uruk

Abstract YOS 20, 87 is a scholarly cuneiform tablet from Hellenistic Uruk. The study of its unusual content shows that it is an Akkadian translation of a collection of Greek official documents issued by the Seleucid administration in the first quarter of the third century BC, concerning the rebuilding of the Bīt Rēš, the main sanctuary of Uruk at the time. These works, which had been recognized on the ground by archaeologists a long time ago, remained unattested until now in the textual records. YOS 20, 87 therefore significantly enhances our understanding of the temple’s history and provides a valuable addition to the dossier of Seleucid euergetic policy in Babylonia.

Umbilical cord hernia with unusual content

Umbilical cord hernia with unusual content

Characterizing restricted and unusual interests in autistic youth.

A broad range of interests characterized by unusual content and/or intensity, labeled as circumscribed interests (CI), are a core diagnostic feature of autism. Recent evidence suggests that a distinction can be drawn between interests that, although characterized by unusually high intensity and/or inflexibility, are otherwise common in terms of their content (e.g., an interest in movies or animals), labeled as restricted interests (RI), and interests that are generally not salient outside of autism (e.g., an interest in traffic lights or categorization), labeled as unusual interests (UI). The current study aimed to further characterize RI and UI by exploring their association with age, sex, IQ, and social motivation, as well as to examine differences in the adaptive benefits and negative impacts of these two subdomains. Parents of 1892 autistic children and adolescents (Mage =10.82, SDage =4.14; 420 females) completed an online survey including the Dimensional Assessment of Restricted and Repetitive Behaviors and the Social Communication Questionnaire. Both RI and UI were found to be highly frequent. Sex-based differences were observed in the content, but not intensity, of CI such that females were more likely to show interests with a social component. Finally, RI and UI showed distinct patterns of association with age, sex, IQ, and social motivation, as well as metrics of adaptive benefits and negative impacts. Findings afford a more nuanced understanding of sex-based differences in CI and, crucially, provide preliminary evidence that RI and UI represent distinct constructs that should be studied independently in future research.

Prodromal stage of late-onset psychosis

IntroductionProdromal stage of psychosis may be an aim of prevention first episode psychosis. In late-onset psychosis it’s low described.ObjectivesThe aim of this investigation is to describe prodromal phase of late-onset psychosis and their connection with psychopathology.Methods74 women with late-onset psychosis (age 64,3±6,7) - late-onset schizophrenia (LOS) (n=49, age 63±8,4), schizoaffective disorder (n=17, age 62,4±6,5), late onset delusion disorder (LoDD) (n=8, age 76,6±4,3) underwent clinical assessment (SOPS, PANSS, HAMD-17), cognitive examination (MMSE, MoCA), structured interviewing on life-time pathology. Spearman’s rho statistics was used.ResultsLOP patients have low prodromal symptoms according to the SOPS score. In LOS patients middle score of SOPS is 18±8,5, in schizoaffective patients middle score of SOPS is 12,3±6,8, and for LoDD SOPS is 13,4 ±4,6. Prodromal disturbances are represented mainly by fragmentary paranoid ideas, thoughts of unusual content, acoasms and affective fluctuations. In LOS patients SOPS negative subscale correlate with HAMD (r=0,384, p<0,05), desorganisation subscale correlate with PANSS common psychopathology subscale (r=0,32, p<0,05) and total PANSS (r=0,28, p<0,05), generous subscale and common SOPS correlate with HAMD (r=0,29, r=0,3, p<0,05). For patients with schizoaffective disorder there is no correlations, and in patients with LoDD SOPS desorganisation subscale negative correlate with PANSS negative subscale (r=-0,71, p<0,05).ConclusionsIn patients with late psychoses, the severity of disorders in the prodromal period is minimal. However, prodromal features are associated with the psychopathology.DisclosureNo significant relationships.

Multispectral Analysis of Miniature Nuragic Bronze Flasks

Miniaturized bronze flasks represent a small portion of a wide metallurgical production that flourished in Sardinia (Italy) between the Final Bronze Age (FBA) and the Early Iron Age (EIA). They replicate a well-known and symbolic type of object, the pilgrims’ flask, common in all Europe and Mediterranean basin, and have but few archaeological parallels. For these reasons, their characterization can be considered important from an archaeological perspective. Three flasks, preserved at the Antiquarium Arborense museum (Oristano), were analyzed by X-Ray Fluorescence Spectroscopy (XRF) and Raman spectroscopy, integrated by multispectral images. The samples, coming from illegal excavations, posed two problems: establishing their authenticity and investigating the alloy composition of such particular objects. All specimens presented a widespread degradation in the outer surface: XRF and Raman spectroscopy indicated the presence of copper oxides, calcium and copper carbonates deposits. The abscence of Zn, a clear marker of forgeries, was not detected by XRF. In two of the flasks, an unusual Sn content above 20%, was detected. For FBA and EIA, especially regarding southern Europe, Sn was extremely rare, and was possibly used with caution. Further results are presented herein.

И.С. ТУРГЕНЕВ, А.А. БЛОК, М.А. ВОЛОШИН И "ЛЕГЕНДА О СВ. ЮЛИАНЕ СТРАННОПРИИМЦЕ" Г. ФЛОБЕРА

Flaubert’s “The Legend of St Julian the Hospitable” was first translated into Russian by I.S. Turgenev, and more recently - in beginning of the 20th century - by M.A. Voloshin and A.A. Blok. The paper addresses Voloshin’s “Preface to the translation of Flaubert’s ‘The Legend of St Julian the Hospitable’”, which he wrote in polemics with Turgenev’s translation. The analysis of the reason of Voloshin’s interest in the text by Flaubert shows that “The legend of St Julian” attracted the poets of the Silver Age with its unusual content, peculiar mysticism and particular - Flauberian - style of presentation. Each of the writers who translated the legend tried to keep the balance between content and style as much as possible. The paper also raises the question of romantic tendencies in Flaubert’s novels on religious subjects.

Cognitive behavioural therapy for help-seeking adolescents and young adults with at-risk-mental state: Effects on subclinical positive symptoms.

Cognitive behavioural therapy (CBT) is effective for at-risk-mental state (ARMS) in reducing/delaying transition to psychosis. However, previous systematic reviews pointed out the small number of trials as a limitation and suggested that additional outcomes should be evaluated, not only prevention of first psychosis episode. No study assessed the CBT effects on subclinical psychotic symptoms. The present study investigated the effects of CBT on the transition risk (primary outcome), and on overall remission from ARMS and severity of subclinical symptoms, that is, unusual content of thought, non-bizarre ideas, perceptual abnormalities, disorganized speech (secondary outcome). CBT consisted of 30 individual weekly sessions over 7 months. Fifty-eight participants with ARMS detected by the Comprehensive Assessment of At-Risk-Mental States were randomized to CBT or control condition. Respectively in the CBT and control groups, 1 (3.40%) and 5 (26.31%) participants at post-treatment and 3 (10.30%) and 8 (42.10%) at follow-up made transition with a difference between the two groups, despite at borderline significance. At post-treatment and follow-up, respectively, the number of participants recovered from ARMS was significantly higher in CBT (76.92% and 61.53%) than in control (10.52% and 15.80%). Participants in the control group reported lower reductions on all the subclinical symptoms over time as compared with those in CBT. This is the first study assessing CBT on subclinical positive symptoms in ARMS. CBT seems to be a tailored approach able to produce short- and long-term benefits on this outcome.

Machine learning approach for identification of threat content in audio messages shared on social media

Now-a-days social media is on boom and it becomes a part of individuals’ daily life. All most all the people communicate with their friends, family members, peers etc using any one of the social media tools (e.g. Twitter, Snapchat, Facebook, and Instagram). People not only share their daily routine with others but sometimes share confidential information with each other in the forms of texts, images and audio messages. Depending on the existing political and economic instability in many countries, there is a need to monitor the content shared among users on social media. A lot of research has undergone in the past on how to monitor the shared content on social media, but they only address the text and images to some extent. According to researcher’s knowledge there exists no research which address to disclose the content in audio messages which are shared on social media. In this paper the researcher’s proposed a methodology which helps in detecting the unusual content shared among users on social media like (hazard, threat etc words) in the form of audio messages using Deep Learning. The results of this research are helpful in monitoring the social media content specially the audio messages by identifying hazards or threats planned before execution and in turn saving the society and mankind from destruction.

Шедевр на заказ. Поздние струнные квартеты Бетховена

Making music to order is a common practice for many composers. At the same time, as one explores specific music pieces a question inevitable begs itself: how writing music to order affects the creative process and the final result. How do such things as the personality of a customer and the relevance of the order to personal aspirations of the composer contribute to the emergence of a musical masterpiece? In this regard, special mention should be given to Ludwig van Beethoven’s last string quartets (Op. 127, 130, 131, 132, 133 “Big Fugue”, 135). These pieces have already received a considerable degree of attention in the research literature. Nevertheless, questions remain about the reasons for this or that turn in the sequence of events and the development of Beethoven’s creativity that impacted the originality of his later works. It is known that the quartets emerged due to an external impulse – an order of the Russian philanthropist, cellist, and a music critic N. B. Golitsyn. Beethoven’s extensive correspondence with Golitsyn, publishing houses, musicians, and friends recreates the sequence of events and the main milestones in the composition of quartets – from the conception to the publication of musical opuses. Of particular interest is the unusual story behind Op. 130. Its grandiose scale, complexity and unusual content created a lot of controversy in assessments and judgments among Beethoven's contemporaries. As a result, at the insistence of the publisher М. Artaria, the finale was replaced, and this piece received an independent existence and a special name – Grand Fugue for String Quartet” (Op. 133). This masterpiece has not lost its relevance even today: it still sparks interest and debate about ideological and figurative content of Quartet Op. 133.

Comparing the roles of landmark visual salience and semantic salience in visual guidance during indoor wayfinding

ABSTRACTLandmark visual salience (characterized by features that contrast with their surroundings and visual peculiarities) and semantic salience (characterized by features with unusual or important meaning and content in the environment) are two important factors that affect an individual’s visual attention during wayfinding. However, empirical evidence regarding which factor dominates visual guidance during indoor wayfinding is rare, especially in real-world environments. In this study, we assumed that semantic salience dominates the guidance of visual attention, which means that semantic salience will correlate with participants’ fixations more significantly than visual salience. Notably, in previous studies, semantic salience was shown to guide visual attention in static images or familiar scenes in a laboratory environment. To validate this assumption, first, we collected the eye movement data of 22 participants as they found their way through a building. We then computed the landmark visual and semantic salience using computer vision models and questionnaires, respectively. Finally, we conducted correlation tests to verify our assumption. The results failed to validate our assumption and show that the role of salience in visual guidance in a real-world wayfinding process is different from the role of salience in perceiving static images or scenes in a laboratory. Visual salience dominates visual attention during indoor wayfinding, but the roles of salience in visual guidance are mixed across different landmark classes and tasks. The results provide new evidence for understanding how pedestrians visually interpret landmark information during real-world indoor wayfinding.

Discourse and Pragmatic Functions of the Dalabon ‘Ergative’ Case-marker

This article discusses the distribution and function of a suffix that has been labelled ‘ergative’ in the literature on Dalabon, a Gunwinyguan (non-Pama-Nyungan) language of south-western Arnhem Land. Our first-hand data reveal that although this marker (-yih) more frequently occurs on A arguments of multivalent clauses, it also appears with significant frequency on S arguments of monovalent clauses, particularly with the verb root yin ‘to say, to think, to do’. We explain this non-canonical distribution with a co-dependent analysis of its discourse and pragmatic functions, summarized by the principle ‘mark out the unexpected referent’, following McGregor’s Expected Actor Principle. These functions differ slightly according to clause type. For both types, the marker has a discourse function of ‘mark out the non-topical referent’: either an A argument that sufficiently threatens the construal of local topics, or an S referent after a long period of deferred topichood (particularly speaker referents). The marker also has a correlating pragmatic function of ‘mark out the contrary referent’: either an A participant acting against the motivations and expectations of other (topical) referents (or of the speaker), or an S participant with an unusual stance or speech content.

Unusual Cysteine Content in V1 Region of gp120 From an Elite Suppressor That Produces Broadly Neutralizing Antibodies.

Although it is now possible to produce recombinant HIV envelope glycoproteins (Envs) with epitopes recognized by the 5–6 major classes of broadly neutralizing antibodies (bNAbs), these have failed to consistently stimulate the formation of bNAbs in immunized animals or humans. In an effort to identify new immunogens better able to elicit bNAbs, we are studying Envs derived from rare individuals who possess bNAbs and are able to control their infection without the need for anti-retroviral drugs (elite supressors or ES), hypothesizing that in at least some people the antibodies may mediate durable virus control. Because virus evolution in people with the ES only phenotype was reported to be limited, we reasoned the Env proteins recovered from these individuals may more closely resemble the Envs that gave rise to bNAbs compared to the highly diverse viruses isolated from normal progressors. Using a phenotypic assay, we screened 25 controllers and identified two for more detailed investigation. In this study, we examined 20 clade B proviral sequences isolated from an African American woman, who had the rare bNAb/ES phenotype. Phylogenetic analysis of proviral envelope sequences demonstrated low genetic diversity. Envelope proteins were unusual in that most possessed two extra cysteines within an elongated V1 region. In this report, we examine the impact of the extra cysteines on the binding to bNAbs, virus infectivity, and sensitivity to neutralization. These data suggest structural motifs in V1 can affect infectivity, and that rare viruses may be prevented from developing escape.

Detecting Fake Images on Social Media using Machine Learning

In this technological era, social media has a major role in people’s daily life. Most people share text, images, and videos on social media frequently (e.g. Twitter, Snapchat, Facebook, and Instagram). Images are one of the most common types of media share among users on social media. So, there is a need for monitoring of images contained in social media. It has become easy for individuals and small groups to fabricate these images and disseminate them widely in a very short time, which threatens the credibility of the news and public confidence in the means of social communication. This research attempted to propose an approach to extracting image content, classify it and verify the authenticity of digital images and uncover manipulation. Instagram is one of the most important websites and mobile image sharing applications on social media. This allows users to take photos, add digital photographic filters and upload pictures. There are many unwanted contents in Instagram's posts such as threats and forged images, which may cause problems to society and national security. This research aims to build a model that can be used to classify Instagram content (images) to detect any threats and forged images. The model was built using deep algorithms learning which is Convolutional Neural Network (CNN), Alexnet network and transfer learning using Alexnet. The results showed that the proposed Alexnet network offers more accurate detection of fake images compared to the other techniques with 97%. The results of this research will be helpful in monitoring and tracking in the shared images in social media for unusual content and forged images detection and to protect social media from electronic attacks and threats.

Association between uncooperativeness and the glucose metabolism of patients with chronic behavioral disorders after severe traumatic brain injury: a cross-sectional retrospective study

BakgroundPatients with behavioral disorders following severe traumatic brain injury (sTBI) often have disorders of consciousness that make expressing their emotional distress difficult. However, no standard method for assessing the unsettled and unforeseen responses that are associated with behavioral disorders has yet to be established. Because the thalamus is known to play a role in maintaining consciousness and cognition, we used 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to examine the association between brain glucose metabolism in the thalamus and behavioral disorders.MethodsWe retrospectively analyzed 70 consecutive patients with sTBI who had been involved in motor vehicle accidents. To assess behavioral disorders, we evaluated 18 symptoms using the Brief Psychiatric Rating Scale (BPRS): Emotional Withdrawal, Conceptual Disorganization, Tension, Mannerisms and Posturing, Motor Retardation, Uncooperativeness, Blunted Affect, Excitement, Somatic Concern, Anxiety, Feeling of Guilt, Grandiosity, Depressive Mood, Hostility, Suspiciousness, Hallucinatory Behavior, Unusual Thought Content, and Disorientation. First, we identified clinical characteristics of sTBI patients with behavioral disorders. Next, we retrospectively analyzed 18F-FDG-PET/CT data to assess how thalamic activity was related with abnormal behaviors.ResultsTwenty-six patients possessed the minimum communicatory ability required for psychiatric interview. Among them, 15 patients (57.7%) were diagnosed with behavioral disorder, 14 of whom had reached a stable psychiatric state after about 426.6 days of treatment. Excitement (13 patients) and uncooperativeness (10 patients) were the most frequently observed symptoms. Available 18F-FDG-PET/CT data indicated that thalamic glucose metabolism was imbalanced and lateralized (p = 0.04) in 6 patients who exhibited uncooperativeness.ConclusionsBehavioral symptoms of excitement and uncooperativeness were common in patients with sTBI, although most symptoms improved as the chronic stage continued. Our data support the idea that imbalanced laterality of glucose metabolism in the thalamus might be related to behavioral disorders characterized by uncooperativeness.Trial registrationUMIN 000029531. Registered 27 March 2017, retrospectively registered.

T165. ULTRA-HIGH FIELD MORPHOMETRY IN DRUG-NAïVE FIRST EPISODE PSYCHOSIS

BackgroundStructural neuroimaging studies report distributed grey matter volume (GMV) deficits in drug-naïve first episode psychosis (FEP), though their relevance to symptom burden and cognitive deficits is currently unclear. When compared to studies in medicated patients and/or patients with established later-stage of psychosis, the GMV deficits reported have been limited in both spatial distribution and effect size, indicating the possibility of stage-specific progression during the clinical course of psychosis. TOPSY (Tracking Outcomes of Psychosis) is one of the first studies intending to track the neurobiological trajectory using ultra-high field (7T) imaging starting from a drug-naïve first episode state. Here, we report the initial findings from the voxel-based morphometry (VBM) of GMV. To our knowledge, this is the first VBM report from drug-naïve FEP subjects obtained using a 7T MRI acquisition.MethodsWe used ultra-high field (7 Tesla) MRI in 28 patients with FEP (satisfying criterion A of DSM-5 schizophrenia) and 18 controls, to evaluate differences in the grey matter. Volume in a voxelwise manner. FEP and controls were matched for age, sex and parental socioeconomic status. Patients were recruited at an early intervention unit (PEPP, London Ontario) and had active psychotic symptoms at the time of scanning. We also obtained abbreviated PANSS (8 items) scores to index the severity of psychosis. Analysis was done using SPM12, after DARTEL based registration and segmentation but without spatial smoothing. 2-tailed voxelwise T-test with FDR correction (p=0.05, 5% rate for false positives) was used. We used multiple regression analysis to predict the scores from processing speed measure (modified Symbol Substitution Test) and the severity of Delusions and Unusual Thought Content (P1 and G9), the 2 symptoms for which most subjects sought treatment in the first place.ResultsPatients had a significant reduction in GMV in left fusiform gyrus (Hedge’s g = 1.98, T= 6.7), and increased GMV in the right precuneus (Hedge’s g = 1.63, T= 5.5) and lingual cortex (Hedge’s g = 1.19, T= 4.0). We did not find any other areas of significant GMV change. Of these 3 circumscribed GMV changes, reduced fusiform GMV was found among FEP patients with lower processing speed (ß=0.45, p=0.04), higher severity of delusions (ß=-0.43, p=0.049) and unusual thought content (ß=-0.59, p=0.01). Increased precuneus GMV was found among FEP patients with higher severity of delusions (ß=0.62, p=0.008) and unusual thought content (ß=0.50, p=0.03). Right lingual changes were not related to the severity of delusions or processing speed scores.DiscussionOur findings suggest that (1) GMV deficits are minimal in drug-naïve FEP subjects, with large effect-size changes concentrated around face processing (fusiform) region (2) GMV increases co-occur with GMV reduction especially in those with most severe delusions and cognitive deficits indicating a role for compensatory plasticity. Subtle early brain structural changes appear to predict symptom burden and cognitive deficits at the time of first clinical presentation with psychosis. Focusing on treatments that manipulate the structure of fusiform cortex could potentially reduce the severity of some of the early symptoms in FEP.

Primary psychosis with comorbid drug abuse and drug-induced psychosis: Diagnostic and clinical evolution at follow up.

The study reports a follow-up assessment of 48 patients with concomitant drug abuse at the first admission for psychosis. We focused on the diagnostic distinction between primary psychosis with concomitant drug abuse and drug induced psychosis, to observe whether the diagnoses are stable over time and whether the clinical course significantly differs. The study examined 25 primary psychotic disorder with comorbid drug abuse and 23 drug-induced psychotic disorder patients. Diagnostic and psychopathological assessments were made at baseline and at follow-up. Mean follow-up period was 4.96 years. Patients with comorbid Drug Abuse exhibited higher scores in the item Unusual Content of Thought at baseline than drug-induced psychotic disorder patients: 5.48 vs 4.39 while the two patients groups did not differ in any of the BPRS items evaluated at follow-up. The primary psychosis with comorbid drug abuse and the substance induced psychosis groups were similar regarding diagnostic stability, and a diagnosis of schizophrenia at follow-up occurred similarly. There was no evidence that Drug Induced psychotic patients' symptoms tend to improve more after cessation of drug abuse. An earlier age of onset was found in primary psychotic patients, particularly for patients diagnosed as affected by schizophrenia at follow up. These results might reflect the uncertainty of the distinction between Primary and Drug Induced Psychosis and the difficulties in applying the DSM IV-TR criteria for diagnosing comorbid drug use disorders and psychotic disorders.

186. Insight into Schizophrenia and Its Relationship With Clinical Symptoms: A Meta-Analysis Involving 20 515 Patients

Abstract Lack of insight is common in patients with schizophrenia and a large number of studies have endeavored to clarify the relationship between level of insight and degree of clinical symptomatology. This study aimed to advance our understanding of this relationship by conducting an up-to-date meta-analysis of all relevant studies published to date. A literature search identified 151 eligible studies published up to August 2016 which together included 20 515 patients with schizophrenia. The statistical associations between insight, its sub-components, and clinical symptoms were analyzed to calculate pooled effects from all studies included. Additional planned analyses included examination of whether clinical, procedural, or demographic variables moderated the strength of these relationships. Results revealed significant negative associations between global insight and positive (ES = −.27), negative (ES = −.22) and global (ES = −.28), symptoms; and a significant though weaker association with depressive symptoms (ES = .20; all < .001). In terms of individual symptoms, insight held the strongest and most negative association with Unusual Thought Content ( = −.46, < .001) and disorganization ( = −.38, < .001). There was substantial variation in the strength of association between individual components of insight and symptoms. Meta-regression analyses revealed that illness duration, number of psychotic episodes, age, and age of onset significantly influences the strength of the relationship between insight and symptoms. Stage of illness, assessment scale, and rater (patient vs. clinician) also moderate these relationships. This study supports the general notion that insight and psychopathology are significantly associated in patients with schizophrenia, however, as the magnitude of associations are generally low to medium, overall findings suggest insight is largely independent from symptomatology. Results are of relevance to both clinical practice and future research studies.