@article{pmid41863358,

title = {Gaming Disorder in First Episode Psychosis: Prevalence and Impact on Symptomatology and Functioning in a Prospective Cohort Study},

author = {Maxime Huot-Lavoie and Olivier Corbeil and Laurent Béchard and Valérie Jomphe and Sophie L'Heureux and Amal Abdel-Baki and Anne-Marie Essiambre and Chantale Thériault and Ingrid Salvini and Olivier Roy and Sébastien Brodeur and Paulina Montserrat Rodriguez Cervantes and William James Desrosiers and Isabelle Giroux and Magali Dufour and Yasser Khazaal and Marie-France Demers and Marc-André Roy},

doi = {10.1093/schbul/sbaf232},

issn = {1745-1701},

year  = {2026},

date = {2026-03-01},

journal = {Schizophr Bull},

volume = {52},

number = {2},

abstract = {BACKGROUND AND HYPOTHESIS: First-episode psychosis (FEP) often coincides with comorbidities that hinder recovery. Gaming disorder (GD) has emerged as a potential concern; however, data on its prevalence and clinical impact in FEP populations remain limited. We hypothesized that GD would be more prevalent among individuals with FEP than in the general population and associated with more severe psychotic symptoms and poorer functional outcomes.nnSTUDY DESIGN: In this prospective cohort study, 284 consecutive patients aged 18-35 years admitted to an Early Intervention Service in Quebec, Canada, were assessed for GD using International Classification of Diseases-11 criteria, with up to 24 months follow-up. Psychotic symptoms and functioning were measured at baseline and at 6-month intervals using the Positive and Negative Syndrome Scale-6 items (PANSS-6) and the Social and Occupational Functioning Assessment Scale (SOFAS).nnSTUDY RESULTS: Gaming disorder was present in 7.04% (95% CI: [4.35%, 10.67%]) of the sample, exceeding the 3.3% general population estimates. Among the 105 patients who reported gaming at least monthly, those with GD (n = 20) more often played Massively Multiplayer Online Role-Playing Games, while non-GD gamers (n = 85) preferred action-adventure games. GD was associated with significantly higher PANSS-6 scores (P = .04), driven by elevated negative symptoms (P = .04). SOFAS scores were consistently lower among individuals with GD, with effect sizes increasing over time.nnCONCLUSIONS: Gaming disorder is a prevalent and clinically meaningful comorbidity in FEP, linked to greater negative symptom burden and functional impairment. These findings support the need for systematic GD screening in early psychosis services and highlight the importance of developing tailored interventions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41684270,

title = {Incidence and predictors of problem gambling in first-episode psychosis: A prospective multicentre cohort study},

author = {Olivier Corbeil and Maxime Huot-Lavoie and Amal Abdel-Baki and Laurent Béchard and Sébastien Brodeur and Laurence Artaud and Prométhéas Constantinides and Christian Jacques and Jean-François Morin and Clairélaine Ouellet-Plamondon and Marco Solmi and Denis Talbot and Michel Dorval and Isabelle Giroux and Marc-André Roy and Marie-France Demers},

doi = {10.1192/j.eurpsy.2026.10167},

issn = {1778-3585},

year  = {2026},

date = {2026-02-01},

journal = {Eur Psychiatry},

volume = {69},

number = {1},

pages = {e29},

abstract = {BACKGROUND: Psychiatric comorbidities are common in first-episode psychosis (FEP) and hinder recovery. Problem gambling (PBG), despite potentially serious clinical consequences, remains under-investigated in this population. This study aimed to estimate the incidence of PBG in FEP and identify predictive factors.nnMETHODS: This prospective cohort study was conducted at two FEP programmes in Quebec, Canada. Individuals aged 18-35 years diagnosed with FEP between November-1-2019 and January-31-2023 were screened for PBG using the Problem Gambling Severity Index through May-1-2023. The primary outcome was incident PBG. Time-varying Cox regression models were used to estimate hazard ratios (HRs) for candidate predictors.nnRESULTS: Among 520 individuals without prior PBG (mean age = 24.6±4.0 years; 28.8% women), 18 developed PBG during a mean follow-up of 478 days, yielding an incidence rate of 2.6 cases/ 100 person-years. In site-adjusted analyses, white ethnicity (HR = 9.7; 95%CI = 1.3-74.8), incomplete high school education (HR = 2.8; 95%CI = 1.1-7.2), stimulant use disorder (HR=2.8; 95%CI = 1.0-7.3), use of D2/D3-5-HT1A partial agonists (HR = 4.6; 95%CI = 1.5-14.1), and prior non-problematic gambling (HR = 3.1; 95%CI = 1.1-8.4) predicted increased risk. Thirteen cases occurred during aripiprazole treatment, which remained associated with increased PBG risk after multivariable adjustment (adjusted HR = 4.7; 95%CI = 1.6-13.9).nnCONCLUSIONS: Despite the limited number of incident cases, these results suggest that PBG is relatively common PBG and is associated with potential risk factors, including white ethnicity, incomplete high school education, stimulant use disorder, prior non-problematic gambling, and treatment with D2/D3-5-HT1A partial agonists, particularly aripiprazole. These findings underscore the importance of routine screening for PBG and risk-informed antipsychotic prescribing in FEP.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41362155,

title = {Integrating gaming disorder into early intervention in first-episode psychosis - current knowledge and future directions},

author = {Maxime Huot-Lavoie and Olivier Cobeil and Olivier Roy and Sophie L'Heureux and Magali Dufour and Josiane Lavallée and Laurent Béchard and Sébastien Brodeur and Marie-France Demers and Marc-André Roy and Yasser Khazaal},

doi = {10.1017/ipm.2025.10150},

issn = {2051-6967},

year  = {2025},

date = {2025-12-01},

journal = {Ir J Psychol Med},

pages = {1--10},

abstract = {Gaming disorder (GD) is increasingly recognized as a clinically significant condition, yet its implications in first-episode psychosis (FEP) remain largely unexplored. This perspective article focuses on the intersection of GD and FEP, highlighting key diagnostic and treatment challenges, including symptom overlap that complicates differential diagnosis, the absence of validated screening tools, and difficulties in sustained patient engagement. Drawing insights from substance use disorder management in FEP, we propose a preliminary clinical framework for integrating GD assessment and intervention into early intervention in psychosis programs. This approach prioritizes comprehensive evaluation, patient-centered care, and a harm-reduction model that supports digital well-being. Addressing GD inFEP populations is crucial for optimizing functional recovery and promoting a holistic, recovery-oriented approach to psychiatric care. Further research is needed to refine screening tools and validate tailored interventions in this population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41307511,

title = {Understanding suicide risk assessment practices in psychotic disorders: insights from Canadian mental health professionals, a preliminary investigation},

author = {Félix Diotte and Christine Genest and Rami Nemeh and Adassa Payant and Hugo Thomas and Iness Arif and Philip Tibbo and Alicia Spidel and Marc-André Roy and Audrey Livet and Colleen Murphy and Tania Lecomte},

doi = {10.1080/09638237.2025.2595611},

issn = {1360-0567},

year  = {2025},

date = {2025-11-01},

journal = {J Ment Health},

pages = {1--10},

abstract = {BACKGROUND: In Canada, more than 4,500 people die by suicide annually, with individuals diagnosed with psychotic disorders being at significantly higher risk. Although the risk factors for suicide in this population are well-established, the assessment of suicide risk remains underexplored.nnAIM: This study examines the practices of mental health professionals working with clients with a psychotic disorder in relation to suicide risk assessment, using the Theory of Planned Behavior (TPB) as a theoretical framework.nnMETHOD: A survey of 148 professionals across Canada was conducted to assess factors influencing the frequency and thoroughness of suicide risk assessments.nnRESULTS: Despite our perceived behavioral control scale having psychometrical flaws, results revealed that social norms were a significant predictor of systematic suicide risk assessments. Professionals identified a lack of time, training, and inadequate clinical tools as major obstacles to thorough assessments. Despite the widespread availability of suicide risk assessment training, many professionals did not feel adequately prepared or confident in conducting such assessments, particularly with clients with a psychotic disorder.nnCONCLUSION: The findings highlight the need for enhanced support, training, and organizational changes to improve the systematic assessment of suicide risk in this vulnerable population.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41139714,

title = {Testing the Transportability of the Psychosis Metabolic Risk Calculator in Canada (Quebec): International External Validation Study},

author = {Sébastien Brodeur and Olivier Corbeil and Laurent Béchard and Maxime Huot-Lavoie and Charles Desmeules and Dominic Oliver and Andrea De Micheli and Emanuele F Osimo and Rachel Upthegrove and Golam M Khandaker and Graham K Murray and Fanny Lajeunesse-Trempe and Gloria Cheung and Josiane Courteau and Chantale Thériault and Marc-André Roy and Marie-France Demers and Benjamin I Perry},

doi = {10.1093/schbul/sbaf174},

issn = {1745-1701},

year  = {2025},

date = {2025-10-01},

journal = {Schizophr Bull},

abstract = {BACKGROUND AND HYPOTHESIS: Cardiometabolic morbidity largely explains premature mortality in people with psychotic disorders and is detectable from psychosis onset. Currently, no accurate cardiometabolic risk prediction tool exists for young people with first-episode psychosis (FEP). The Psychosis Metabolic Risk Calculator (PsyMetRiC) aims to bridge this gap, but its accuracy and potential clinical usefulness in North American populations remain unverified.nnSTUDY DESIGN: The external validity of PsyMetRiC, developed in the United Kingdom to predict the risk of incident metabolic syndrome (MetS) up to 6 years after a FEP, was assessed using the data from the Quebec Psychosis Early Intervention Clinic. PsyMetRiC comprises 2 penalized logistic regression models: a full-model including age, sex, ethnicity, body mass index (BMI), smoking status, prescription of metabolically-active antipsychotic medication, high-density lipoprotein (HDL), and triglyceride concentrations; and a partial-model excluding biochemical predictors. Patients aged 16-35 years, diagnosed with FEP between 2004 and 2023 without pre-existing MetS, and with>12 months follow-up were included. Predictive performance of PsyMetRiC was assessed by discrimination (C-statistic), calibration (calibration plots), and clinical usefulness (decision curve analysis). The race and ethnicity predictor was refined to better represent the North American population.nnSTUDY RESULTS: Among 559 included patients (mean age 24.1 years ±4.1; 22.5% female), 18.2% developed MetS during a mean follow-up of 1.7 ± 1.3 years. Compared with the UK development cohort, the Canadian sample exhibited a higher BMI, lower HDL cholesterol, lower triglycerides, lower blood glucose, and lower systolic blood pressure. Discrimination performance was acceptable (full model C = 0.74, 95% CI, 0.70-0.77; intercept = 0.225; slope = 1.278; partial model C = 0.70, 95% CI, 0.67-0.74; intercept = -0.555; slope = 0.993). After updating the model with a race and ethnicity predictor calibrated to locally representative categories, performance improved slightly (full model C = 0.74, 95% CI, 0.71-0.77; intercept = 0.000; slope = 1.001; partial model C = 0.71, 95% CI, 0.68-0.74; intercept = 0.001; slope = 1.005).nnCONCLUSIONS: This study provides the first external validation of PsyMetRiC in a North American sample. Further research is essential before routine clinical implementation, but PsyMetRiC offers promise as a tool for early detection of cardiometabolic risk in early psychosis, guiding personalized treatments to diminish long-term physical health impacts.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41087831,

title = {Using a Learning Health System to Integrate Peer Support in Early Intervention Services for Psychosis in Quebec: Protocol for a Participatory, Mixed-Methods Study (the PAIRPEP Project)},

author = {Beatrice Todesco and Srividya N Iyer and Manuela Ferrari and Marc-André Roy and Marie-Hélène Morin and Julie Marguerite Deschênes and Camille Arbaud and Gabriel Julien and Annie Bossé and Mary Anne Levasseur and Amal Abdel-Baki},

doi = {10.1111/eip.70092},

issn = {1751-7893},

year  = {2025},

date = {2025-10-01},

journal = {Early Interv Psychiatry},

volume = {19},

number = {10},

pages = {e70092},

abstract = {INTRODUCTION: Since 2019, SARPEP (Système Apprenant Rapide pour les programmes de Premiers Épisodes Psychotiques), a rapid learning health system (RLHS) for Quebec's Early Intervention for Psychosis Services, operates to bridge the evidence-practice gap across the province. Despite strong stakeholder support and government recommendations, peer support services remained poorly available. To address this gap, since 2023, the PAIRPEP project was co-developed to support and evaluate the implementation of peer support and family peer support. This paper describes the co-designed study protocol, embedded within this RLHS.nnMETHODS: This participatory, mixed-methods study aims to examine the implementation of the PAIRPEP intervention longitudinally over 3 years across 12 Early Intervention Services and its impact on multiple stakeholders. Informed by the Medical Research Council framework for complex interventions, the project includes a co-designed (with multiple stakeholders) multimodal capacity-building program with specific components developed to overcome barriers to integrating peer support and family peer support. Quantitative questionnaires are collected every 4 months from clinicians while youth and families can complete surveys at any convenient time, via QR codes available in clinics, through the RLHS electronic platform. Focus groups are conducted annually over 3 years with eight stakeholder groups. The analysis integrates findings using thematic synthesis and joint displays to assess convergence and divergence across methods and perspectives.nnRESULTS AND CONCLUSION: This protocol paper outlines the study's co-design, procedures and anticipated contributions. Embedding large-scale innovative intervention implementation (such as peer support) within an RLHS can foster real-time feedback, iterative refinement and inform clinical practice and policies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40904211,

title = {Factors shaping the decision-making process to continue or discontinue antipsychotics: exploratory qualitative study of 12 individuals in remission from first-episode psychosis},

author = {Laurent Béchard and Elizabeth Anderson and Olivier Corbeil and Maxime Huot-Lavoie and Sébastien Brodeur and Amal Abdel-Baki and Charles Massé and Mina Gabriel-Courval and Marie-Ève Coté and Annie LeBlanc and Marc-André Roy and Marie-France Demers and Sophie Lauzier},

doi = {10.1192/bjo.2025.10817},

issn = {2056-4724},

year  = {2025},

date = {2025-09-01},

journal = {BJPsych Open},

volume = {11},

number = {5},

pages = {e193},

abstract = {BACKGROUND: The decision-making process regarding antipsychotic continuation or discontinuation following remission from first-episode psychosis (FEP) remains complex and underresearched. While discontinuation increases the risk of relapse, concerns over long-term side-effects such as metabolic disturbances and extrapyramidal symptoms also exist. Current guidelines recommend maintaining antipsychotics for 1-5 years, emphasising shared decision-making (SDM) between clinicians and patients.nnAIMS: This study aimed to explore the decision-making process and describe the factors influencing the decision to discontinue or continue antipsychotic treatment following remission from FEP, from the patients' perspective.nnMETHOD: A descriptive qualitative study was conducted with 12 individuals in remission from FEP who received care at early intervention services in Quebec, Canada. Data were collected through online semi-structured interviews and analysed thematically to identify key factors influencing treatment decisions.nnRESULTS: The decision-making process was activated by treatment reflection triggers and shaped by various perceptions (of illness, treatment and stigma) and relationships (with friends, family and the clinical team), ultimately leading to decisions to either discontinue, continue (at standard or reduced dose) or remain ambivalent. This dynamic process was guided by participants' motivators, such as well-being and societal contribution. Most participants felt that discontinuation discussions were not initiated by the clinical team.nnCONCLUSIONS: The decision-making process is driven by motivators that were found to be linked to the concept of personal recovery. This study highlights the need for proactive, personalised discussions between clinicians and patients. Future research should focus on decision aids tailored to the FEP population to support SDM and improve treatment outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40450961,

title = {A pilot randomized controlled trial of a digital cannabis harm reduction intervention for young adults with first-episode psychosis who use cannabis},

author = {Stephanie Coronado-Montoya and Amal Abdel-Baki and Paule Bodson-Clermont and David Boucher-Roy and José Côté and Candice E Crocker and David Crockford and Jean-Gabriel Daneault and Simon Dubreucq and Maxime Dussault-Laurendeau and Benedikt Fischer and Pamela Lachance-Touchette and Tania Lecomte and Sophie L'Heureux and Clairélaine Ouellet-Plamondon and Marc-André Roy and Ovidiu Tatar and Philip G Tibbo and Marie Villeneuve and Anne Wittevrongel and Didier Jutras-Aswad},

doi = {10.1016/j.psychres.2025.116553},

issn = {1872-7123},

year  = {2025},

date = {2025-08-01},

journal = {Psychiatry Res},

volume = {350},

pages = {116553},

abstract = {Cannabis use is widespread and associated with worsened prognosis for young adults with first-episode psychosis (FEP). Few cannabis harm reduction interventions have been evaluated for this population, despite potential to improve outcomes in those not ready for cannabis abstinence/reduction-focused interventions. This study aimed to determine a) the acceptability of a digital harm reduction intervention, the Cannabis Harm-reducing App to Manage Practices Safely (CHAMPS) and b) the feasibility of conducting a trial comparing FEP-specialized early intervention services (EIS)+CHAMPS versus EIS-only with this population. We conducted a multi-site pilot randomized controlled trial comparing both arms in 101 young adults (18 - 35 years old) with FEP using cannabis and attending EIS. Primary outcomes were trial retention rate (i.e., proportion of randomized participants retained at week 6; trial feasibility assessment) and CHAMPS completion rate (i.e., proportion of intervention participants completing four of six modules; CHAMPS acceptability assessment). Trial retention rate above 60 % indicated feasibility and completion rate above 50 % indicated acceptability. Additional outcomes included harm reduction strategy use, motivation to change cannabis behaviors, cannabis-related problems, cannabis use, psychotic symptoms and dependence severity, assessed at baseline, weeks 6, 12 and 18. Trial retention was 82.2 % and completion rate was 58.8 %, suggesting trial feasibility and CHAMPS acceptability. Signals of possible improvement in the intervention group were observed regarding harm reduction strategy use, motivation to change behaviors, cannabis-related problems and cannabis use frequency. This study supports conducting an efficacy trial assessing the potential of CHAMPS in improving outcomes for young adults with psychosis using cannabis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40808461,

title = {Being well understood and generating interest during verbal interactions: the role of Theory of Mind and clinical symptoms in people with schizophrenia spectrum disorders},

author = {Audrey Cayouette and Caroline Cellard and Marion Fossard and Dominique Knutsen and Marc-André Roy and Maxime Rancourt and Stéphanie D'Amours and Rose Bourget and Laurie Bolduc and Amelie Achim},

doi = {10.1098/rstb.2023.0506},

issn = {1471-2970},

year  = {2025},

date = {2025-08-01},

journal = {Philos Trans R Soc Lond B Biol Sci},

volume = {380},

number = {1932},

pages = {20230506},

abstract = {People with schizophrenia spectrum disorders (SSD) present with communication impairments. This study aimed to determine whether individuals with SSD make it less easy or interesting to perform a joint task with them relative to community controls (CO), and to examine the link between clinical symptoms and theory of mind (ToM). Fifty-one outpatients with SSD and 68 CO performed the storytelling in sequence task (STST) with an interaction partner. Four raters subsequently listened to the STST audio recordings and scored how easily they could place the images of the narrated stories in the correct order (Facility ratings), how interesting they found the stories (Interest ratings) and how expressive they found the voice (Expressivity ratings). Symptoms were assessed using the Positive and Negative Syndrome Scale and ToM using the Combined Stories Test. The Facility, Interest and Expressivity ratings were lower in SSD than in CO. In SSD, the Facility ratings were positively associated with ToM and negatively associated with several symptom dimensions. The Interest and Expressivity ratings were strongly linked together and negatively associated with Negative symptoms. ToM deficits in SSD may contribute to difficulties communicating clearly. The strong association between Expressivity and Interesting ratings raises important questions regarding the real-life impacts of reduced expressivity.This article is part of the theme issue 'At the heart of human communication: new views on the complex relationship between pragmatics and Theory of Mind'.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40403141,

title = {Lived experience of gaming disorder among people with psychotic disorders: implications for tailored interventions and clinical management},

author = {Maxime Huot-Lavoie and Laurent Béchard and Olivier Corbeil and Olivier Roy and Sophie L'Heureux and Ingrid Salvini and Catherine Lehoux and Anne-Marie Essiambre and Chantale Thériault and Sébastien Brodeur and Marie-France Demers and Yasser Khazaal and Marc-André Roy},

doi = {10.1097/YCO.0000000000001013},

issn = {1473-6578},

year  = {2025},

date = {2025-07-01},

journal = {Curr Opin Psychiatry},

volume = {38},

number = {4},

pages = {295--301},

abstract = {PURPOSE OF REVIEW: Despite growing recognition of the impact of Gaming Disorder in individuals with psychotic disorders, little is known about the clinical and personal implications of this dual diagnosis. Preliminary data suggest that Gaming Disorder may be associated with increased psychotic symptoms and reduced occupational and social functioning. However, insight from lived experience remain largely absent, despite their importance.nnRECENT FINDINGS: This review synthesizes recent literature on the comorbidity between Gaming Disorder and psychotic disorders, highlighting the scarcity of research in this emerging field. It also presents preliminary findings from an ongoing qualitative study focussing on the lived experiences of individuals receiving early psychosis intervention. These data focus on participants' motivations for gaming and their perceptions of both positive and negative effects gaming has on their life.nnSUMMARY: This review underscores the significant lack of data on the dual diagnosis of Gaming Disorder and psychosis. Early qualitative insights reveal diverse gaming motivations, including symptom regulation, anxiety management, cognitive stimulation, and social connection. These first-person accounts emphasize the functional role of gaming and the need for recovery-oriented care. Integrating lived experience into research and clinical practice can improve relevance, support nuanced interventions, and advance our understanding of behavioral addictions in early psychosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}