Discussion
This aims to improve our understanding of the relationship between GD
and PD. It will be the first empirical study that explores this
comorbidity, which has only been previously discussed in a few case
reports. The results will not only confirm or refute the association
between GD and PD, but also provide a more detailed description of the
factors linking these two conditions and their consequences.
A notable strength of this study is the systematic screening procedure
of GD that has been developed, which eliminates any detection bias and
improves sensibility. All patients newly admitted to either of the two
participating FEP programs will undergo the same screening process,
irrespective of their disease progression and treatment history. This
systematic approach is particularly crucial given the limited knowledge
about the consequences of GD, which may be underestimated by both
patients and clinicians. On completion of the study, the screening
procedure for is expected to be implemented across all FEP programs in
Quebec, and potentially in other regions in Canada as well.
The study’s large sample size and extended follow-up duration are also
significant strengths, ensuring sufficient statistical power to generate
meaningful findings. The lack of a consent requirement, combined with
the diverse areas served by the two participating FEP programs,
including urban and rural areas, ensures that the sample is
representative of the FEP population in Quebec. Consequently, the
findings are expected to be generalizable to all FEP programs in the
province.
By collecting variables that are routinely documented by clinicians as
part of their systematic clinical follow-up, the ecological validity of
this study is further strengthened. The close collaboration between our
research team and clinicians facilitates knowledge transfer and improves
the quality of patient care.
The primary limitation of this research project lies in its dependence
on clinician cooperation in adhering to the GD screening procedure, as
we have no control over their clinical practices and prescribing
patterns. However, we have implemented a monitoring committee to assess
clinicians’ adherence to the GD screening process on a regular basis.
Furthermore, all new clinicians joining the study receive comprehensive
training in the utilization of this procedure. By considering these
methodological aspects collectively, we anticipate that the results will
substantially enhance our understanding of this understudied
comorbidity.
Abbreviations
FEP: First-episode psychosis; GD: Gaming Disorder; DSM-5: Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition; ICD-11:
International Classification of Diseases, 11thEdition; PANSS: Positive and Negative Syndrome Scale; CGI: Clinical
Global Impression Scale; SOFAS: Social and Occupational Functioning
Assessment Scale; REDCap: Research Electronic Data Capture
Aknowledgements
The authors are thankful to the clinical staff working at the 2 study
sites for their precious collaboration and their unwavering dedication
to patients’ recovery.
Authors contributions
MHL conceptualized the study, developed the screening and assessment
procedure for GD implemented it at both study sites, wrote the original
draft, reviewed, and edited the final draft. CD and OC wrote the
original draft, reviewed and edited the final draft. OC, LB, EF, SB,
AME, CD contributed to data collection, reviewed and edited the final
draft. CT managed the grant funding and coordinated research activity.
ZAAH and JR reviewed the final draft for accuracy, clarity, coherence.
AAB supervised the conduct of the study at site #2. YK and IG provided
input in developing the screening and assessment procedure for GD,
critically reviewing and editing the original draft. MAR and MFD
supervised the conduct of the study at site #1, supervised all stages
of the study, and critically reviewed and edited the original draft. MFD
coordinated responsibility for the grant funding. All authors reviewed
and approved the final draft.
Funding
This project is supported by a Mitacs Grant (IT34510). MHL is also
supported by the Frederick Banting and Charles Best Canada Graduate
Scholarship Doctoral Awards from the Canadian Institute of Health
Research (FID-172598). The funders played no role in this study, and we
have no restrictions regarding the submission of this protocol for
publication.
Data availability
Not applicable.