@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{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{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{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}

}

@article{pmid39320504,

title = {Prevalence of schizophrenia spectrum and other psychotic disorders in problem gambling: A systematic review and meta-analysis},

author = {Olivier Corbeil and Laurent Béchard and Élizabeth Anderson and Maxime Huot-Lavoie and Charles Desmeules and Lauryann Bachand and Sébastien Brodeur and Pierre-Hugues Carmichael and Christian Jacques and Marco Solmi and Michel Dorval and Isabelle Giroux and Marc-André Roy and Marie-France Demers},

doi = {10.1192/j.eurpsy.2024.1777},

issn = {1778-3585},

year  = {2024},

date = {2024-09-01},

journal = {Eur Psychiatry},

volume = {67},

number = {1},

pages = {e56},

abstract = {BACKGROUND: High rates of psychiatric comorbidities have been found in people with problem gambling (PBG), including substance use, anxiety, and mood disorders. Psychotic disorders have received less attention, although this comorbidity is expected to have a significant impact on the course, consequences, and treatment of PBG. This review aimed to estimate the prevalence of psychotic disorders in PBG.nnMETHODS: Medline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of Science, and ProQuest were searched on November 1, 2023, without language restrictions. Studies involving people with PBG and reporting the prevalence of schizophrenia spectrum and other psychotic disorders were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for systematic reviews of prevalence data. The pooled prevalence of psychotic disorders was calculated using a random effects generalized linear mixed model and presented with forest plots.nnRESULTS: Of 1,271 records screened, 22 studies ( = 19,131) were included. The overall prevalence of psychotic disorders was 4.9% (95% CI, 3.6-6.5%,  = 88%). A lower prevalence was found in surveyed/recruited populations, compared with treatment-seeking individuals and register-based studies. No differences were found for factors such as treatment setting (inpatient/outpatient), diagnoses of psychotic disorders (schizophrenia only/other psychotic disorders), and assessment time frame (current/lifetime). The majority of included studies had a moderate risk of bias.nnCONCLUSIONS: These findings highlight the relevance of screening problem gamblers for schizophrenia spectrum and other psychotic disorders, as well as any other comorbid mental health conditions, given the significant impact such comorbidities can have on the recovery process.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38996632,

title = {Psychotic Disorders and exosomes: An overview of current evidence and future directions},

author = {Charles Desmeules and Olivier Corbeil and Maxime Huot-Lavoie and Laurent Béchard and Sébastien Brodeur and Marie-France Demers and Marc-André Roy and Jessica Deslauriers},

doi = {10.1016/j.psychres.2024.116066},

issn = {1872-7123},

year  = {2024},

date = {2024-09-01},

journal = {Psychiatry Res},

volume = {339},

pages = {116066},

abstract = {Due to its reliance on heterogeneous symptomatology, the accurate diagnosis of psychotic disorders remains a challenging task in clinical practice. Precise and early diagnosis of psychotic disorders facilitates early intervention, which has been shown to have substantial benefits for long-term outcomes. Still, the lack of specific biomarkers is an important limitation in early diagnosis and intervention. Exosomes, which act as messengers between cells, including brain cells, contain a vast array of molecules that hold promise for unveiling disorder-specific abnormalities. In this review, we discuss recent evidence highlighting the potential of circulating exosomes and brain-derived exosomes as valuable tools for the identification of accessible, non-invasive, and blood-based biomarkers of psychotic symptomatology and risk. We discuss current limitations in biomarker discovery studies focusing on exosomes. To enhance diagnosis specificity and treatment response, we also provide guidance for future investigations that need to target biomarkers of risk and relapse, as well as consider duration of untreated psychosis, biological sex, and other factors in the multifactorial biosignature of psychosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38566334,

title = {Problem gambling in psychotic disorders: A systematic review and meta-analysis of prevalence},

author = {Olivier Corbeil and Élizabeth Anderson and Laurent Béchard and Charles Desmeules and Maxime Huot-Lavoie and Lauryann Bachand and Sébastien Brodeur and Pierre-Hugues Carmichael and Christian Jacques and Marco Solmi and Isabelle Giroux and Michel Dorval and Marie-France Demers and Marc-André Roy},

doi = {10.1111/acps.13686},

issn = {1600-0447},

year  = {2024},

date = {2024-06-01},

journal = {Acta Psychiatr Scand},

volume = {149},

number = {6},

pages = {445--457},

abstract = {INTRODUCTION: Problem gambling (PBG) is more common in people with mental health disorders, including substance use, bipolar, and personality disorders, than in the general population. Although individuals with psychotic disorders might be expected to be more vulnerable to PBG, fewer studies have focused on this comorbidity. The aim of this review was to estimate the prevalence of PBG in people with psychotic disorders.nnMETHODS: Medline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of science, and ProQuest were searched on November 1, 2023, without language restrictions. Observational and experimental studies including individuals with psychotic disorders and reporting the prevalence of PBG were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal for systematic reviews of prevalence data. The pooled prevalence of PBG was calculated using a fixed effects generalized linear mixed model and presented through forest plots.nnRESULTS: Of 1271 records screened, 12 studies (n = 3443) were included. The overall prevalence of PBG was 8.7% (95% CI = 7.8%-9.7%, I = 69%). A lower prevalence was found in studies with a low risk of bias (5.6%; 95% CI = 4.4%-7.0%) compared with studies with a moderate risk of bias (10.4%; 95% CI = 9.2%-11.7%). Different methods used to assess PBG also contributed to the heterogeneity found.nnCONCLUSION: This meta-analysis found substantial heterogeneity, partly due to the risk of bias of the included studies and a lack of uniformity in PBG assessment. Although more research is needed to identify those at increased risk for PBG, its relatively high prevalence warrants routine screening for gambling in clinical practice.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}