@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{pmid41117326,

title = {Home Care Services Use in Older Adults Living with Severe Mental Illness: Care Patterns Variations Before and After an Incident Dementia Diagnosis: Utilisation des services de soins à domicile chez les personnes âgées atteintes de troubles de santé mentale graves : Variation des modèles de soins avant et après un diagnostic de trouble neurocognitif},

author = {Isabelle Dufour and Véronique Legault and Sarah Emmanuella Brou and Sébastien Brodeur and Josiane Courteau and Yohann Moanahere Chiu},

doi = {10.1177/07067437251387542},

issn = {1497-0015},

year  = {2025},

date = {2025-10-01},

journal = {Can J Psychiatry},

pages = {7067437251387542},

abstract = {ObjectiveOlder adults with severe mental illness (SMI) represent a complex population with various healthcare needs, even more so when they subsequently develop dementia. While home care (HC) services are advocated for both patients with SMI and dementia, little is known regarding real-life practices, especially for individuals having both conditions. Therefore, we aimed to describe healthcare use and transitions in older adults with SMI across HC user profiles, before and after an incident dementia diagnosis.MethodWe used a retrospective cohort study drawn from Quebec health administrative data on individuals with SMI living in the community, aged 65 and older, and who received a first dementia diagnosis between 2013 and 2015. We described healthcare use 8 months prior and 2 years after the diagnosis, including hospital admissions, visits to the emergency department (ED), and long-term care (LTC) placement.ResultsA total of 3,713 individuals were included, 53% of whom were already receiving HC services before the diagnosis (Group 1), 28% received HC services only after the diagnosis (Group 2), and 19% did not receive any HC (Group 3). While Group 1 showed the highest overall healthcare use before the diagnosis, the most striking increase after the diagnosis was observed for Group 2, catching up with Group 1's levels for many indicators, and even surpassing them in some cases. HC was mainly introduced in the four months following the diagnosis in Group 2. Group 3, while showing the lowest healthcare use throughout the study period, had the second highest mortality rate after Group 1. Groups 2 and 3 were transferred to LTC and died at younger ages than Group 1, in average.ConclusionsThis study highlights potential missed opportunities for intervention, such as an earlier HC introduction which could contribute to prevent an increase in hospitalizations and ED visits, or any HC in Group 3 to mitigate mortality risk and postpone LTC placement.},

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{pmid40568737,

title = {Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status?},

author = {Mélanie Couture and Josiane Courteau and Sébastien Brodeur and Yohann M Chiu and Mireille Courteau and Émilie Dubé and Nina Thomas and Alain Lesage and Éric Fombonne and Isabelle Dufour},

doi = {10.1002/aur.70072},

issn = {1939-3806},

year  = {2025},

date = {2025-08-01},

journal = {Autism Res},

volume = {18},

number = {8},

pages = {1674--1692},

abstract = {The aim of this study was to compare the healthcare trajectories (HCTs) 2 years after a first diagnosis of autism according to sex, age at diagnosis, and intellectual or developmental disabilities (IDD) status. This is a retrospective cohort study using health administrative data from Québec, Canada. The cohort included all individuals with a first diagnosis of autism registered by a physician between April 2012 and March 2015. HCTs were stratified by sex, presence of IDD, and age at diagnosis (youth, adult), and analyzed using state sequence analysis across healthcare settings, providers, and reasons for use. Our cohort included 5289 individuals, 76.6% were male, and 26.3% were adults at the time of diagnosis. The healthcare use decreased slightly over time, though intensity was higher in females. Sex differences in HCTs were strongly influenced by IDD status and age at diagnosis. While no significant sex differences were observed in HCTs for individuals with IDD diagnosed with autism in adulthood, the psychiatric condition profiles showed notable differences between males and females. Hospital days nearly doubled for females diagnosed in childhood compared to males, while males with IDD diagnosed with autism in childhood and males without IDD diagnosed in adulthood had fewer physical illness visits. Although physical and mental health challenges appear largely managed in ambulatory care during youth, high hospitalization rates in those diagnosed in adulthood, particularly females and those with IDD, highlight concerns about continuity of care and avoidable hospitalizations for these subgroups of patients.},

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{pmid40596839,

title = {Pathways to autism diagnosis in adulthood},

author = {Isabelle Dufour and Yohann Chiu and Sébastien Brodeur and Mireille Courteau and Josiane Courteau and Émilie Dubé and Alain Lesage and Éric Fombonne and Mélanie Couture},

doi = {10.1186/s11689-025-09627-3},

issn = {1866-1955},

year  = {2025},

date = {2025-07-01},

journal = {J Neurodev Disord},

volume = {17},

number = {1},

pages = {35},

abstract = {BACKGROUND: This study explored Trajectories of Diagnoses (TDs) preceding a first diagnosis of autism in adulthood.nnMETHODS: This retrospective cohort study used health administrative data from Quebec, Canada, and included all adults with a first recorded diagnosis of autism between 2012 and 2017. A TDs was defined as a succession of medical records of psychiatric and/or neurodevelopmental conditions over time. These TDs were retrospectively analyzed from 2002 to 2017, using a state sequence analysis of diagnoses, in order: Autism, Intellectual or developmental disabilities (IDDs), Schizophrenia spectrum disorder (SSD), Bipolar Disorder (BD), Depressive Disorder (DD), Anxiety Disorder (AD), Attention-deficit/hyperactivity disorder (ADHD), and Other psychiatric and/or neurodevelopmental conditions.nnRESULTS: The cohort included 2799 adults with a first recorded diagnosis of autism between 2012 and 2017. Several psychiatric and/or neurodevelopmental conditions were recorded since 2002, including AD (77.5%), DD (58.0%), SSD (49.4%), BD (48.3%), and IDDs (33.2%). Results revealed 5 distinct types of TDs. Types 1 (63.8%), 2 (17.6%) and 3 (6%) represented individuals in younger age groups with similar characteristics but with very different sequences of diagnoses, characterized by mixed diagnoses in type 1, SSD and AD in Type 2, and IDDs, DD, AD, and ADHD in type 3. Types 4 and 5 (9.0% and 3.6%), representing middle-aged/older groups, displayed distinctive TDs associated with high healthcare use, almost entirely associated with SSD (Type 4) and BD (Type 5).nnCONCLUSION: This study proposes a complementary examination of the multiple pathways to diagnosis experienced by adults, highlighting the need to address differential diagnosis and co-occurring psychiatric and neurodevelopmental conditions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}