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

A Better Understanding of the Association Between Problem Gambling and Psychotic Disorders in Young Adults: a New Path Towards Recovery

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.

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.