Prospective Multicenter Cohort Study Evaluating the Incidence and Risk Factors for Problem Gambling Among Young Adults With First-episode Psychosis

Laval University520 enrolled

Overview

The aims of this propsective cohort study are to get a better understanding of the association between problem gambling and psychotic disorders among young adults with first-episode psychosis. The main questions to be answered are: 1. What is the incidence of problem gambling in this population? 2. What are the predictors of problem gambling in this population? To do so, putative predictors of problem gambling will be analyzed using Cox regression models: * Sociodemographics (e.g., age, gender identity, ethnicity, level of education, employment); * Psychiatric comorbidities (e.g., substance use disorders, cluster B personality disorders); * Antipsychotic use (first/second-generation, third-generation \[aripiprazole, brexpiprazole, cariprazine\]); * Prior gambling history.

All Cox regression models will be adjusted for site-effect. Further multivariable models will be constructed to examine the association between antipsychotic use (as continuous exposure) and incident PBG using the directed acyclic graphs approach to adjust for confounders.

Study Type

OBSERVATIONAL

Enrollment

520

Conditions

Gambling Disorder Psychotic Disorders

Interventions

Use of first/second generation antipsychotics, use of third-generation antipsychotics, use of aripiprazole specifically

Psychiatric comorbiditiesOTHER

Substance use disorders, cluster B personality disorders, anxiety disorder, major depressive disorder, attention-deficit/hyperactivity disorder, tobacco smoking

Sociodemographics/socioeconomic statusOTHER

Age, gender identity, ethnicity, highest educational attainment, employment, at school, homelessness, in a relationship

Gambling historyOTHER

Non-problematic gambling at the time of admission and/or previous 12 months

Clinical variablesOTHER

Main psychiatric diagnosis, history of psychiatric hospitalizations, severity of illness (CGI-S), functioning (SOFAS), concomitant psychotropic medications use

Eligibility

Sex: ALLMin age: 18 YearsMax age: 35 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 18 to 35 years old; * Diagnosis of first-episode psychosis (i.e., DSM-5 diagnosis of schizophrenia spectrum and other psychotic disorders, as well as DSM-5 bipolar disorder with psychotic features). Exclusion Criteria: * Active/prior PBG at te time of admission; * Loss to follow-up within first three months; * DSM-5 diagnosis of psychotic disorder due to a medical condition; * Severe intellectual disability.

Locations (2)

Montreal University Hospital Center

Montreal, Quebec, Canada

Quebec Mental Health University Institute

Québec, Quebec, Canada

Outcomes

Primary Outcomes

Problem gambling

i) Diagnosis of gambling disorder according to DSM-5 criteria, established by the treating psychiatrist, and/or; ii) Problem gambling according to a score of 8 and more on the Problem Gambling Severity Index, as questioned by the clinical case manager and/or treating psychiatrist

Time frame: Outcome assessed at every 6-month time point, from patients admission until the first occurrence of the primary outcome, loss to follow-up, or May 1, 2023.

Data from ClinicalTrials.gov

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