Gambling Disorder, Psychotic Disorders
Conditions
Keywords
Gambling, Psychotic disorder, Schizophrenia, Cohort, Multicenter, Prospective, Observational, Incidence, Risk factors
Brief summary
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.
Detailed description
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.
Interventions
DRUGAntipsychotic use
Use of first/second generation antipsychotics, use of third-generation antipsychotics, use of aripiprazole specifically
OTHERPsychiatric comorbidities
Substance use disorders, cluster B personality disorders, anxiety disorder, major depressive disorder, attention-deficit/hyperactivity disorder, tobacco smoking
OTHERSociodemographics/socioeconomic status
Age, gender identity, ethnicity, highest educational attainment, employment, at school, homelessness, in a relationship
OTHERGambling history
Non-problematic gambling at the time of admission and/or previous 12 months
OTHERClinical variables
Main psychiatric diagnosis, history of psychiatric hospitalizations, severity of illness (CGI-S), functioning (SOFAS), concomitant psychotropic medications use
Sponsors
Fonds de la Recherche en Santé du Québec
Laval University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Problem gambling | 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. | 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 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity analysis restricted to DSM-5 gambling disorder | 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. | DSM-5 diagnosis of gambling disorder by treating psychiatrist |
Countries
Canada
Outcome results
None listed