Delphine Raucher-Chéné, MD, PhD
Researcher, Douglas Research Centre
Psychiatrist, Douglas Mental Health University Institute
Assistant Professor, Department of Psychiatry, McGill University
Division: Clinical Research
Dr. Raucher-Chéné’s research program focuses on the development of a comprehensive understanding of the cognitive psychopathology of severe mental illness (i.e., bipolar disorder and schizophrenia-spectrum disorder), across stages, from neuroimaging to remediation. The main objectives of this group are:
- To develop a cognitive neuroscience program to expand our current knowledge on cognitive impairments in bipolar disorder (BD) and their neuronal substrates using state-of-the-art imaging protocols;
- To develop a measurement-based care approach across the different stages of BD disorder, using digital technology;
- To implement innovative and effective psychosocial interventions for persons living with BD.
Dr. Raucher-Chéné completed her French MD degree in psychiatry in 2010 and has worked for ten years as a full-time clinician in an academic psychiatric department in France. She furthered her research training by undertaking an M.Sc. in neuropsychology (2012), a Ph.D. in psychology (2018), and a postdoctoral fellowship (2019-2021) at McGill/Douglas under the supervision of Dr. Martin Lepage before joining McGill University as an Assistant Professor in 2023.
- ISBD Best Poster Awardee (2020) – International Society for Bipolar Disorders Conference
- Postdoctoral scholarship (2019) – Quebec Bio-Imaging Network
- Short PhD mobility fellowship program (2016) – Reims Champagne-Ardenne University (France) Aston Brain Centre, Aston University, Birmingham, UK
- Student mobility fellowship program (2002) – Conseil Général du Maine-et-Loire (France)
- Liverpool School of Medicine, Liverpool, UK
Key publications
- Percie du Sert, O., Unrau, J.*, Gauthier, C. J., Chakravarty, M., Malla, A., Lepage, M., & Raucher-Chéné, D. (2023). Cerebralblood flow in schizophrenia: A systematicreview and meta-analysis of MRI-basedstudies. Progress in Neuro-Psychopharmacology and BiologicalPsychiatry, 121, 110669. https://doi.org/https://doi.org/10.1016/j.pnpbp.2022.110669
- Lavigne, K. M., Sauvé, G., Raucher-Chéné, D., Guimond, S., Lecomte, T., Bowie, C. R., Menon, M., Lal, S., Woodward, T. S., Bodnar, M. D., & Lepage, M. (2022). Remote cognitive assessment in severe mental illness: a scoping review. Schizophrenia, 8(1), 14. https://doi.org/10.1038/s41537-022-00219-x
- Mendelson, D.*, Thibaudeau, É., Sauvé, G., Lavigne, K. M., Bowie, C. R., Menon, M., Woodward, T. S., Lepage, M., & Raucher-Chéné, D. (2021). Remote group therapies for cognitive health in schizophrenia-spectrum disorders: Feasible, acceptable, engaging. SchizophrResCogn, 100230.https://doi.org/https://doi.org/10.1016/j.scog.2021.100230
- Raucher-Chéné, D., Thibaudeau, E., Sauvé, G., Lavigne, K. M., & Lepage, M. (2021). Understanding others as a mediator between verbal memory and negative symptoms in schizophrenia-spectrum disorder. J PsychiatrRes, 143, 429-435. https://doi.org/10.1016/j.jpsychires.2021.10.007
- Henry, A., Raucher-Chéné, D., Obert, A., Gobin, P., Vucurovic, K., Barrière, S., Sacré, S., Portefaix, C., Gierski, F., Caillies, S., & Kaladjian, A. (2021). Investigation of the neural correlates of mentalizing through the Dynamic Inference Task, a new naturalistic task of social cognition. NeuroImage, 243, 118499. https://doi.org/https://doi.org/10.1016/j.neuroimage.2021.118499
Publications
2026
Au-Yeung, Christy; Christophe, N Keita; Lavigne, Katie M; Raucher-Chéné, Delphine; Lepage, Martin
Chicken or the egg: The relationship between cognitive deficits and negative symptoms in first episode psychosis Journal Article
In: Schizophr Res, vol. 290, pp. 125–133, 2026, ISSN: 1573-2509.
@article{pmid41687329,
title = {Chicken or the egg: The relationship between cognitive deficits and negative symptoms in first episode psychosis},
author = {Christy Au-Yeung and N Keita Christophe and Katie M Lavigne and Delphine Raucher-Chéné and Martin Lepage},
doi = {10.1016/j.schres.2026.02.008},
issn = {1573-2509},
year = {2026},
date = {2026-04-01},
journal = {Schizophr Res},
volume = {290},
pages = {125--133},
abstract = {BACKGROUND: Cognitive impairments and negative symptoms (NS) represent an unmet therapeutic need in psychotic disorders. Both NS and cognitive impairments, are key predictors of functioning. Both also appear during the illness prodrome, highlighting their relevance to the etiology of psychosis. Cross-sectional and longitudinal links between NS and cognition have been established, suggesting a common underlying foundation. Thus, investigating the relationship between cognition and NS is particularly relevant, especially given the clinical fluctuations seen in the early stages of psychosis and the marked cognitive deficits present throughout the illness.nnOBJECTIVE: The following study aims to investigate the longitudinal relationship between NS and cognition and whether, over the first two years following psychosis onset, 1) NS influences cognition, 2) cognition influences NS, or 3) the relationship is bidirectional.nnMETHODS: We used data from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (2010-2014). Participants underwent early treatment intervention, with assessments at baseline, 12, and 24 months using the Brief Assessment of Cognition in Schizophrenia and the Positive and Negative Syndrome Scale (n = 404). Random intercept cross-lagged panel models, which consider the temporal sequence of effects, were created to model the relationship between cognition and NS through the three timepoints over two years.nnRESULTS: We found a unidirectional relationship- declines in cognitive function predicted increased NS severity, while NS did not predict future cognitive function.nnCONCLUSION: This suggests that cognitive deficits may contribute to the development or exacerbation of NS. These findings underscore the role of cognition on NS trajectories and open new avenues for early psychosis treatments.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Cognitive impairments and negative symptoms (NS) represent an unmet therapeutic need in psychotic disorders. Both NS and cognitive impairments, are key predictors of functioning. Both also appear during the illness prodrome, highlighting their relevance to the etiology of psychosis. Cross-sectional and longitudinal links between NS and cognition have been established, suggesting a common underlying foundation. Thus, investigating the relationship between cognition and NS is particularly relevant, especially given the clinical fluctuations seen in the early stages of psychosis and the marked cognitive deficits present throughout the illness.nnOBJECTIVE: The following study aims to investigate the longitudinal relationship between NS and cognition and whether, over the first two years following psychosis onset, 1) NS influences cognition, 2) cognition influences NS, or 3) the relationship is bidirectional.nnMETHODS: We used data from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (2010-2014). Participants underwent early treatment intervention, with assessments at baseline, 12, and 24 months using the Brief Assessment of Cognition in Schizophrenia and the Positive and Negative Syndrome Scale (n = 404). Random intercept cross-lagged panel models, which consider the temporal sequence of effects, were created to model the relationship between cognition and NS through the three timepoints over two years.nnRESULTS: We found a unidirectional relationship- declines in cognitive function predicted increased NS severity, while NS did not predict future cognitive function.nnCONCLUSION: This suggests that cognitive deficits may contribute to the development or exacerbation of NS. These findings underscore the role of cognition on NS trajectories and open new avenues for early psychosis treatments.
Chau, Leena W; Murphy, Jill K; Morton, Emma; Provencher, Martin D; Raucher-Chene, Delphine; Barnes, Steven J; Michalak, Erin E
Cultural Adaptation of a Digital Mobile App for Bipolar Disorder (PolarUs): Protocol for a Qualitative Co-Design Study Journal Article
In: JMIR Res Protoc, vol. 15, pp. e92600, 2026, ISSN: 1929-0748.
@article{pmid41950274,
title = {Cultural Adaptation of a Digital Mobile App for Bipolar Disorder (PolarUs): Protocol for a Qualitative Co-Design Study},
author = {Leena W Chau and Jill K Murphy and Emma Morton and Martin D Provencher and Delphine Raucher-Chene and Steven J Barnes and Erin E Michalak},
doi = {10.2196/92600},
issn = {1929-0748},
year = {2026},
date = {2026-04-01},
journal = {JMIR Res Protoc},
volume = {15},
pages = {e92600},
abstract = {BACKGROUND: Bipolar disorder (BD) affects approximately 40 million people worldwide and is a chronic, potentially disabling mood disorder. Although effective treatments exist, access to evidence-informed psychosocial care remains limited, particularly for culturally and linguistically diverse populations, contributing to persistent global treatment gaps. Digital mental health interventions (DMHIs), such as smartphone apps, offer a promising means to improve access to self-management support and quality of life (QoL), an outcome prioritized by people with BD and in clinical guidelines. However, most apps for BD lack quality and are not culturally adapted or co-designed with people with BD, limiting relevance and engagement. PolarUs (mobile app) is an evidence-informed DMHI developed using co-design with people with BD. The app is structured on the core 14 domains from the Quality of Life in BD scale, the only BD-tailored scale, combined with psychoeducation on self-management strategies and QoL. A recent pilot study demonstrated promising QoL, clinical, and feasibility outcomes.nnOBJECTIVE: This study aims to culturally and linguistically adapt the PolarUs app into French, Chinese, and Spanish for the North American context using qualitative and co-design methods.nnMETHODS: Guided by community-based participatory research principles, whereby end users are engaged throughout the research process, and the Ecological Validity Framework of Bernal et al, we will engage advisory groups of people with lived experience from each linguistic community throughout the cultural adaptation process. Semimonthly virtual meetings will support systematic cultural adaptation of the self-management strategies, affirmations, and resources while maintaining fidelity to core evidence-based components. This will include cultural tailoring of app content and the identification of culturally appropriate resources. Advisory groups will also contribute to the cointerpretation of findings and the co-design of culturally appropriate recruitment and implementation strategies of PolarUs for a future clinical trial. Meetings will be recorded and coanalyzed as research data with advisory groups using qualitative reflexive thematic analysis to capture advisory group perspectives and experiences.nnRESULTS: This study was funded in October 2024. As of January 31, 2026, we enrolled 7 participants, and the results are expected to be published in the fall of 2026.nnCONCLUSIONS: The findings will support the development of a culturally appropriate DMHI for BD for additional linguistic communities, advance cultural adaptation methodologies, and inform preparation for a future clinical trial. This study will produce the first culturally adapted, BD-specific DMHI developed through co-design using a community-based participatory research approach with multilingual end users from traditionally underserved communities, advancing equitable access, engagement, and scalability of DMHIs for BD and digital health care more broadly.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Bipolar disorder (BD) affects approximately 40 million people worldwide and is a chronic, potentially disabling mood disorder. Although effective treatments exist, access to evidence-informed psychosocial care remains limited, particularly for culturally and linguistically diverse populations, contributing to persistent global treatment gaps. Digital mental health interventions (DMHIs), such as smartphone apps, offer a promising means to improve access to self-management support and quality of life (QoL), an outcome prioritized by people with BD and in clinical guidelines. However, most apps for BD lack quality and are not culturally adapted or co-designed with people with BD, limiting relevance and engagement. PolarUs (mobile app) is an evidence-informed DMHI developed using co-design with people with BD. The app is structured on the core 14 domains from the Quality of Life in BD scale, the only BD-tailored scale, combined with psychoeducation on self-management strategies and QoL. A recent pilot study demonstrated promising QoL, clinical, and feasibility outcomes.nnOBJECTIVE: This study aims to culturally and linguistically adapt the PolarUs app into French, Chinese, and Spanish for the North American context using qualitative and co-design methods.nnMETHODS: Guided by community-based participatory research principles, whereby end users are engaged throughout the research process, and the Ecological Validity Framework of Bernal et al, we will engage advisory groups of people with lived experience from each linguistic community throughout the cultural adaptation process. Semimonthly virtual meetings will support systematic cultural adaptation of the self-management strategies, affirmations, and resources while maintaining fidelity to core evidence-based components. This will include cultural tailoring of app content and the identification of culturally appropriate resources. Advisory groups will also contribute to the cointerpretation of findings and the co-design of culturally appropriate recruitment and implementation strategies of PolarUs for a future clinical trial. Meetings will be recorded and coanalyzed as research data with advisory groups using qualitative reflexive thematic analysis to capture advisory group perspectives and experiences.nnRESULTS: This study was funded in October 2024. As of January 31, 2026, we enrolled 7 participants, and the results are expected to be published in the fall of 2026.nnCONCLUSIONS: The findings will support the development of a culturally appropriate DMHI for BD for additional linguistic communities, advance cultural adaptation methodologies, and inform preparation for a future clinical trial. This study will produce the first culturally adapted, BD-specific DMHI developed through co-design using a community-based participatory research approach with multilingual end users from traditionally underserved communities, advancing equitable access, engagement, and scalability of DMHIs for BD and digital health care more broadly.
Jacobson, Samantha; Carling, Hannah; Sarraf, Lisa; Draper, Ethan; Jacobson, Sarah; St-James, Mélodie; Misiasz, Chris; Williamson, Sianna; Thibaudeau, Elisabeth; Sauvé, Geneviève; Lavigne, Katie M; Raucher-Chéné, Delphine
Digital tools for assessing bipolar disorder: A scoping review of the current landscape Journal Article
In: Neurosci Appl, vol. 5, pp. 107004, 2026, ISSN: 2772-4085.
@article{pmid42094292,
title = {Digital tools for assessing bipolar disorder: A scoping review of the current landscape},
author = {Samantha Jacobson and Hannah Carling and Lisa Sarraf and Ethan Draper and Sarah Jacobson and Mélodie St-James and Chris Misiasz and Sianna Williamson and Elisabeth Thibaudeau and Geneviève Sauvé and Katie M Lavigne and Delphine Raucher-Chéné},
doi = {10.1016/j.nsa.2026.107004},
issn = {2772-4085},
year = {2026},
date = {2026-01-01},
journal = {Neurosci Appl},
volume = {5},
pages = {107004},
abstract = {This scoping review synthesizes current evidence on the use of digital tools to assess bipolar disorder across clinical, behavioral, physiological, and psychosocial domains. An electronic search of Ovid, CINAHL, ClinicalTrials.gov, and OpenGrey, completed in March 2026, yielded 374 articles for full-text evaluation. Of which 214 studies met the inclusion criteria and were included in the final review. Most studies were conducted in the Global North, particularly the United States, Denmark, the United Kingdom, and Germany. Participant samples varied widely, although cohorts were typically comprised of young adults and predominantly female, with implications for the contexts in which digital markers have been evaluated across illness stages and demographic groups, and for the extent to which these findings can be generalized. Across studies, mood, sleep, and activity were the most frequently assessed domains, whereas physiological signals, cognitive performance, and communication-based features were less frequently examined, highlighting several underdeveloped but clinically relevant areas. Common measurement approaches included self-report questionnaires and ecological momentary assessment, whilst passive sensing approaches, such as accelerometry, geolocation, device-use metrics, speech features, and actigraphy, captured continuous indicators of sleep-wake cycles, mobility, and activity rhythms. The present synthesis reveals a clear temporal shift: since 2015, the field has transitioned from primarily active, self-report study designs toward multimodal, sensor-based methodologies, driven by advances in smartphones, wearable technologies, and sophisticated data-processing pipelines. Overall, this review highlights substantial progress in digital monitoring for bipolar disorder, with emerging tools offering ecologically valid, continuous assessment of core symptom dimensions. These developments lay essential groundwork for multimodal digital biomarkers with potential applications in early detection, tailored intervention, improved patient outcomes, and longitudinal care.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This scoping review synthesizes current evidence on the use of digital tools to assess bipolar disorder across clinical, behavioral, physiological, and psychosocial domains. An electronic search of Ovid, CINAHL, ClinicalTrials.gov, and OpenGrey, completed in March 2026, yielded 374 articles for full-text evaluation. Of which 214 studies met the inclusion criteria and were included in the final review. Most studies were conducted in the Global North, particularly the United States, Denmark, the United Kingdom, and Germany. Participant samples varied widely, although cohorts were typically comprised of young adults and predominantly female, with implications for the contexts in which digital markers have been evaluated across illness stages and demographic groups, and for the extent to which these findings can be generalized. Across studies, mood, sleep, and activity were the most frequently assessed domains, whereas physiological signals, cognitive performance, and communication-based features were less frequently examined, highlighting several underdeveloped but clinically relevant areas. Common measurement approaches included self-report questionnaires and ecological momentary assessment, whilst passive sensing approaches, such as accelerometry, geolocation, device-use metrics, speech features, and actigraphy, captured continuous indicators of sleep-wake cycles, mobility, and activity rhythms. The present synthesis reveals a clear temporal shift: since 2015, the field has transitioned from primarily active, self-report study designs toward multimodal, sensor-based methodologies, driven by advances in smartphones, wearable technologies, and sophisticated data-processing pipelines. Overall, this review highlights substantial progress in digital monitoring for bipolar disorder, with emerging tools offering ecologically valid, continuous assessment of core symptom dimensions. These developments lay essential groundwork for multimodal digital biomarkers with potential applications in early detection, tailored intervention, improved patient outcomes, and longitudinal care.
2025
Totzek, Jana F; Shah, Jai L; Young, Alexandra L; Malla, Ashok; Joober, Ridha; Raucher-Chéné, Delphine; Lepage, Martin; Lavigne, Katie M
From resting-state functional hippocampal centrality to functional outcome: An extended neurocognitive model of psychosis Journal Article
In: Psychiatry Res, vol. 350, pp. 116538, 2025, ISSN: 1872-7123.
@article{pmid40413924,
title = {From resting-state functional hippocampal centrality to functional outcome: An extended neurocognitive model of psychosis},
author = {Jana F Totzek and Jai L Shah and Alexandra L Young and Ashok Malla and Ridha Joober and Delphine Raucher-Chéné and Martin Lepage and Katie M Lavigne},
doi = {10.1016/j.psychres.2025.116538},
issn = {1872-7123},
year = {2025},
date = {2025-08-01},
journal = {Psychiatry Res},
volume = {350},
pages = {116538},
abstract = {BACKGROUND: We previously proposed a neurocognitive model of psychosis in which reduced morphometric hippocampal-cortical connectivity precedes impaired episodic memory, social cognition, negative symptoms, and functional outcome. We provided support for this model in a patient subtype, and aimed to extend these findings to resting-state functional MRI to potentially explain the progression for a broader range of patients.nnMETHODS: We used a subsample of our previous analysis consisting of 54 patients with first-episode psychosis and 52 controls and applied the machine-learning algorithm Subtype and Stage Inference, which combines clustering and disease progression modeling, to the patient data for rs-functional hippocampal connectivity, episodic memory, social cognition, negative symptoms and functioning.nnRESULTS: We identified three subtypes, with Subtype 0 being unimpaired on the markers, Subtype 1 showing impaired hippocampal connectivity and episodic memory, and Subtype 2 showing impaired memory and a trend for impaired functioning. We identified similar progression patterns to our previously published morphometric results in functional MRI data (hippocampal dysconnectivity preceded cognition, symptoms, and functioning in one subtype and followed these alterations in another subtype). We further show that the impairments in our previously published and current findings across modalities do not necessarily overlap in patients, hinting towards an additive effect of morphometric and resting-state connectivity in explaining the neurocognitive underpinnings of this model.nnCONCLUSION: Our results provide an extension of our previous work and build the foundation for a multimodal neurocognitive model of psychosis, potentially elucidating this aspect of illness progression in psychosis for a broader range of patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: We previously proposed a neurocognitive model of psychosis in which reduced morphometric hippocampal-cortical connectivity precedes impaired episodic memory, social cognition, negative symptoms, and functional outcome. We provided support for this model in a patient subtype, and aimed to extend these findings to resting-state functional MRI to potentially explain the progression for a broader range of patients.nnMETHODS: We used a subsample of our previous analysis consisting of 54 patients with first-episode psychosis and 52 controls and applied the machine-learning algorithm Subtype and Stage Inference, which combines clustering and disease progression modeling, to the patient data for rs-functional hippocampal connectivity, episodic memory, social cognition, negative symptoms and functioning.nnRESULTS: We identified three subtypes, with Subtype 0 being unimpaired on the markers, Subtype 1 showing impaired hippocampal connectivity and episodic memory, and Subtype 2 showing impaired memory and a trend for impaired functioning. We identified similar progression patterns to our previously published morphometric results in functional MRI data (hippocampal dysconnectivity preceded cognition, symptoms, and functioning in one subtype and followed these alterations in another subtype). We further show that the impairments in our previously published and current findings across modalities do not necessarily overlap in patients, hinting towards an additive effect of morphometric and resting-state connectivity in explaining the neurocognitive underpinnings of this model.nnCONCLUSION: Our results provide an extension of our previous work and build the foundation for a multimodal neurocognitive model of psychosis, potentially elucidating this aspect of illness progression in psychosis for a broader range of patients.
Ronat, Lucas A; Raucher-Chéné, Delphine; Lavigne, Katie M; Chakravarty, Mallar; Joober, Ridha; Malla, Ashok; Shah, Jai; Lepage, Martin
Longitudinal clinical outcomes based on cognitive and hippocampal clusters of first episode psychosis Journal Article
In: Prog Neuropsychopharmacol Biol Psychiatry, vol. 139, pp. 111392, 2025, ISSN: 1878-4216.
@article{pmid40320230,
title = {Longitudinal clinical outcomes based on cognitive and hippocampal clusters of first episode psychosis},
author = {Lucas A Ronat and Delphine Raucher-Chéné and Katie M Lavigne and Mallar Chakravarty and Ridha Joober and Ashok Malla and Jai Shah and Martin Lepage},
doi = {10.1016/j.pnpbp.2025.111392},
issn = {1878-4216},
year = {2025},
date = {2025-06-01},
journal = {Prog Neuropsychopharmacol Biol Psychiatry},
volume = {139},
pages = {111392},
abstract = {BACKGROUND: In first episode psychosis (FEP), cognitive impairments are core features contributing to clinical and functional heterogeneity. Significant impairment indicates greater clinical severity throughout the course of the illness, particularly for negative symptoms. Hippocampal volume is smaller in FEP than in healthy controls (notably subfields like Cornu Ammonis 1-3 and subiculum), and is related to cognitive impairments and negative symptoms. The aim of this study was to compare the clinical and functional trajectories of FEP subgroups as a function of cognitive performance and hippocampal volumes.nnMETHODS: One hundred FEP patients and sixty healthy controls initially assessed using the CogState research battery, underwent 3 T MRI to extract hippocampal subfields and adjacent structures using the MAGeT brain algorithm. Clinical assessments were carried out for negative (Motivational and Pleasure - MAP, and diminished expression - EXP) and depressive symptoms, and global functioning. Measurements were taken at 4 time points (3, 9, 15, 21 months following program entry). Based on available first timepoint standardized cognitive and hippocampal features, using healthy controls as reference, clusters were determined by a hierarchical ascending classification. Their clinical and functional longitudinal trajectories were analyzed using linear mixed-effects models.nnRESULTS: Three baseline clusters were revealed: normal-range hippocampal volume with low attention, working and verbal memory (FEP 0), small hippocampus with low verbal memory and social cognition (FEP 1), and large hippocampus with low verbal memory (FEP 2). At baseline, the clusters did not differ on symptoms severity and global functioning. Longitudinally, MAP, EXP and depressive symptoms decreased over time in FEP 0. Global functioning improved in FEP 0 and FEP 1, while FEP 2 was clinically and functionally stable over time. Longitudinal inter-group comparisons did not yield any significant differences.nnCONCLUSION: The clusters were dissociated between hippocampus and cognition, but their trajectories suggest the importance of hippocampal integrity in the clinical and/or functional outcome. Future studies are needed to understand intervention efficiency depending on hippocampal integrity.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: In first episode psychosis (FEP), cognitive impairments are core features contributing to clinical and functional heterogeneity. Significant impairment indicates greater clinical severity throughout the course of the illness, particularly for negative symptoms. Hippocampal volume is smaller in FEP than in healthy controls (notably subfields like Cornu Ammonis 1-3 and subiculum), and is related to cognitive impairments and negative symptoms. The aim of this study was to compare the clinical and functional trajectories of FEP subgroups as a function of cognitive performance and hippocampal volumes.nnMETHODS: One hundred FEP patients and sixty healthy controls initially assessed using the CogState research battery, underwent 3 T MRI to extract hippocampal subfields and adjacent structures using the MAGeT brain algorithm. Clinical assessments were carried out for negative (Motivational and Pleasure - MAP, and diminished expression - EXP) and depressive symptoms, and global functioning. Measurements were taken at 4 time points (3, 9, 15, 21 months following program entry). Based on available first timepoint standardized cognitive and hippocampal features, using healthy controls as reference, clusters were determined by a hierarchical ascending classification. Their clinical and functional longitudinal trajectories were analyzed using linear mixed-effects models.nnRESULTS: Three baseline clusters were revealed: normal-range hippocampal volume with low attention, working and verbal memory (FEP 0), small hippocampus with low verbal memory and social cognition (FEP 1), and large hippocampus with low verbal memory (FEP 2). At baseline, the clusters did not differ on symptoms severity and global functioning. Longitudinally, MAP, EXP and depressive symptoms decreased over time in FEP 0. Global functioning improved in FEP 0 and FEP 1, while FEP 2 was clinically and functionally stable over time. Longitudinal inter-group comparisons did not yield any significant differences.nnCONCLUSION: The clusters were dissociated between hippocampus and cognition, but their trajectories suggest the importance of hippocampal integrity in the clinical and/or functional outcome. Future studies are needed to understand intervention efficiency depending on hippocampal integrity.
Carling, Hannah; Thibaudeau, Elisabeth; Sauvé, Geneviève; Penney, Danielle; Lavigne, Katie M; Lepage, Martin; Raucher-Chéné, Delphine
How do negative symptoms and social cognitive impairments overlap? Clustering analyses on patients living with schizophrenia-spectrum disorder Journal Article
In: Soc Cogn Affect Neurosci, 2025, ISSN: 1749-5024.
@article{pmid40576457,
title = {How do negative symptoms and social cognitive impairments overlap? Clustering analyses on patients living with schizophrenia-spectrum disorder},
author = {Hannah Carling and Elisabeth Thibaudeau and Geneviève Sauvé and Danielle Penney and Katie M Lavigne and Martin Lepage and Delphine Raucher-Chéné},
doi = {10.1093/scan/nsaf061},
issn = {1749-5024},
year = {2025},
date = {2025-06-01},
journal = {Soc Cogn Affect Neurosci},
abstract = {Negative symptoms and social cognition (SC) are intertwined in schizophrenia spectrum disorders (SSD) but the structure of this interaction is not yet fully understood. We employed cluster analyses to advance our understanding of the relationship between negative symptom severity and SC. We sought to identify discrete groups of patients as a function of two factors of negative symptoms-Motivation and Pleasure (MAP) and Expressivity (EXP) - and two domains of SC: emotion recognition (ER) and theory of mind (ToM). We conducted two cluster analyses to determine data-driven subgroups using two independent samples of SSD participants. The first conducted with an open dataset (n = 296) and the second with a local sample (n = 138), to assess replicability. The first cluster analysis revealed a 3-cluster solution. Both analyses highlighted distinct profiles: a 'Relatively Preserved' Profile; a 'Combined Impairment' profile, with high negative symptoms and impaired ER and ToM; and a 'MAP' profile, with high MAP symptoms, some EXP symptoms, and slightly to moderately impaired ER and ToM. Reducing the heterogeneity in clinical presentations of SSD patients on these dimensions of negative symptoms and social cognition provides relevant information that could contribute to a more effective selection of interventions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Negative symptoms and social cognition (SC) are intertwined in schizophrenia spectrum disorders (SSD) but the structure of this interaction is not yet fully understood. We employed cluster analyses to advance our understanding of the relationship between negative symptom severity and SC. We sought to identify discrete groups of patients as a function of two factors of negative symptoms-Motivation and Pleasure (MAP) and Expressivity (EXP) - and two domains of SC: emotion recognition (ER) and theory of mind (ToM). We conducted two cluster analyses to determine data-driven subgroups using two independent samples of SSD participants. The first conducted with an open dataset (n = 296) and the second with a local sample (n = 138), to assess replicability. The first cluster analysis revealed a 3-cluster solution. Both analyses highlighted distinct profiles: a 'Relatively Preserved' Profile; a 'Combined Impairment' profile, with high negative symptoms and impaired ER and ToM; and a 'MAP' profile, with high MAP symptoms, some EXP symptoms, and slightly to moderately impaired ER and ToM. Reducing the heterogeneity in clinical presentations of SSD patients on these dimensions of negative symptoms and social cognition provides relevant information that could contribute to a more effective selection of interventions.
du Sert, Olivier Percie; Unrau, Joshua; Dama, Manish; Palaniyappan, Lena; Shah, Jai; Joober, Ridha; Raucher-Chéné, Delphine; Malla, Ashok; Lepage, Martin
In: Schizophr Bull, 2025, ISSN: 1745-1701.
@article{pmid40319470,
title = {Latent Trajectories of Positive, Negative Symptoms and Functioning in Early Intervention Services for First-Episode Psychosis: A 2-Year Follow-Up Study},
author = {Olivier Percie du Sert and Joshua Unrau and Manish Dama and Lena Palaniyappan and Jai Shah and Ridha Joober and Delphine Raucher-Chéné and Ashok Malla and Martin Lepage},
doi = {10.1093/schbul/sbaf045},
issn = {1745-1701},
year = {2025},
date = {2025-05-01},
journal = {Schizophr Bull},
abstract = {BACKGROUND: From the first episode (FEP), the course of psychosis is marked by substantial heterogeneity of clinical and functional outcomes which poses significant challenges in providing prognostic guidance to patients and families. To better understand such heterogeneity within the context of early intervention services (EIS), this study aimed to examine latent trajectories of positive and negative symptoms and functioning among FEP individuals undergoing EIS.nnSTUDY DESIGN: The Prevention and Early Intervention Program for Psychoses (PEPP-Montreal) is a 2-year EIS for FEP that conducted longitudinal assessments of 689 individuals aged 14-35, including sociodemographics, cognition, psychopathology, and functioning. Latent growth mixture modeling was used to identify distinct patterns of clinical and functional trajectories. The inter-relationship between trajectories, and the association of trajectory membership with baseline characteristics and distal outcomes were investigated using the manual 3-step approach.nnSTUDY RESULTS: Two positive symptom trajectories (Stable-low-32%, Fluctuating-68%,), 3 negative symptom trajectories (Decreasing-41%, Fluctuating-15%, and Stable-high-44%), and 2 functioning trajectories (Increasing-57%, Stable-moderate-43%) were identified. Early treatment response, particularly on negative symptoms, consistently and strongly predicted better outcome trajectories (OR = [3.4-5.5]). Trajectories of higher symptom severity were associated with trajectory of worse functioning (RR = [1.5-2.2]), which exhibited lower rates of clinical and functional remission.nnCONCLUSION: These findings offer insights into clinically meaningful subgroups of individuals that could inform the prognosis of FEP and the development of individually tailored EIS. Individuals who do not show early improvement in negative symptoms may benefit from earlier psychosocial interventions specifically targeting actionable factors that contribute to secondary negative symptoms.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: From the first episode (FEP), the course of psychosis is marked by substantial heterogeneity of clinical and functional outcomes which poses significant challenges in providing prognostic guidance to patients and families. To better understand such heterogeneity within the context of early intervention services (EIS), this study aimed to examine latent trajectories of positive and negative symptoms and functioning among FEP individuals undergoing EIS.nnSTUDY DESIGN: The Prevention and Early Intervention Program for Psychoses (PEPP-Montreal) is a 2-year EIS for FEP that conducted longitudinal assessments of 689 individuals aged 14-35, including sociodemographics, cognition, psychopathology, and functioning. Latent growth mixture modeling was used to identify distinct patterns of clinical and functional trajectories. The inter-relationship between trajectories, and the association of trajectory membership with baseline characteristics and distal outcomes were investigated using the manual 3-step approach.nnSTUDY RESULTS: Two positive symptom trajectories (Stable-low-32%, Fluctuating-68%,), 3 negative symptom trajectories (Decreasing-41%, Fluctuating-15%, and Stable-high-44%), and 2 functioning trajectories (Increasing-57%, Stable-moderate-43%) were identified. Early treatment response, particularly on negative symptoms, consistently and strongly predicted better outcome trajectories (OR = [3.4-5.5]). Trajectories of higher symptom severity were associated with trajectory of worse functioning (RR = [1.5-2.2]), which exhibited lower rates of clinical and functional remission.nnCONCLUSION: These findings offer insights into clinically meaningful subgroups of individuals that could inform the prognosis of FEP and the development of individually tailored EIS. Individuals who do not show early improvement in negative symptoms may benefit from earlier psychosocial interventions specifically targeting actionable factors that contribute to secondary negative symptoms.
Belkacem, Agnès; Lavigne, Katie M; Raucher-Chéné, Delphine; Makowski, Carolina; Chakravarty, Mallar; Joober, Ridha; Malla, Ashok; Shah, Jai; Lepage, Martin
Association of anticholinergic burden with hippocampal subfields volume in first-episode psychosis Journal Article
In: Psychiatry Res Neuroimaging, vol. 348, pp. 111968, 2025, ISSN: 1872-7506.
@article{pmid40015233,
title = {Association of anticholinergic burden with hippocampal subfields volume in first-episode psychosis},
author = {Agnès Belkacem and Katie M Lavigne and Delphine Raucher-Chéné and Carolina Makowski and Mallar Chakravarty and Ridha Joober and Ashok Malla and Jai Shah and Martin Lepage},
doi = {10.1016/j.pscychresns.2025.111968},
issn = {1872-7506},
year = {2025},
date = {2025-04-01},
journal = {Psychiatry Res Neuroimaging},
volume = {348},
pages = {111968},
abstract = {Polypharmacy is relatively common in early psychosis, but little attention has been paid to the anticholinergic burden of medication use (the cumulative effect of medications that block the cholinergic system). Evidence suggests that anticholinergic burden is associated with cognitive deficits and that hippocampal dysfunction may be involved in those impairments. We aimed to examine this association in a cohort of patients with first-episode psychosis. We hypothesized that patients with the highest burden would experience a more significant reduction in hippocampal volume compared to those with low burden and healthy controls, both at baseline (3 months) and at month 12. Patients (n = 82; low burden [n = 64] and high burden [n = 18], defined by a Drug Burden Index cut-off of 1) followed at the PEPP-Montreal clinic, and controls (n = 55) completed a 3T MRI at both timepoints. After controlling for antipsychotic dosage at both timepoints, results at baseline and over time revealed a greater reduction in left fimbria volumes in high-burden patients compared to low-burden patients and controls. Overall, the associations observed between high anticholinergic burden and hippocampal volume provide further evidence for considering this dimension when prescribing medication in early psychosis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Polypharmacy is relatively common in early psychosis, but little attention has been paid to the anticholinergic burden of medication use (the cumulative effect of medications that block the cholinergic system). Evidence suggests that anticholinergic burden is associated with cognitive deficits and that hippocampal dysfunction may be involved in those impairments. We aimed to examine this association in a cohort of patients with first-episode psychosis. We hypothesized that patients with the highest burden would experience a more significant reduction in hippocampal volume compared to those with low burden and healthy controls, both at baseline (3 months) and at month 12. Patients (n = 82; low burden [n = 64] and high burden [n = 18], defined by a Drug Burden Index cut-off of 1) followed at the PEPP-Montreal clinic, and controls (n = 55) completed a 3T MRI at both timepoints. After controlling for antipsychotic dosage at both timepoints, results at baseline and over time revealed a greater reduction in left fimbria volumes in high-burden patients compared to low-burden patients and controls. Overall, the associations observed between high anticholinergic burden and hippocampal volume provide further evidence for considering this dimension when prescribing medication in early psychosis.
Rae, Jesse; Lavigne, Katie M; Sauvé, Geneviève; Lepage, Martin; Raucher-Chéné, Delphine
In: Can J Psychiatry, vol. 70, no. 4, pp. 301–311, 2025, ISSN: 1497-0015.
@article{pmid40116708,
title = {Mapping Insight Dimensions and Symptom Dynamics in Schizophrenia: A Data-Driven Network Approach: Cartographie des dimensions d'insight et de la dynamique symptomatique dans la schizophrénie: une approche par réseau fondée sur les données},
author = {Jesse Rae and Katie M Lavigne and Geneviève Sauvé and Martin Lepage and Delphine Raucher-Chéné},
doi = {10.1177/07067437251329074},
issn = {1497-0015},
year = {2025},
date = {2025-04-01},
journal = {Can J Psychiatry},
volume = {70},
number = {4},
pages = {301--311},
abstract = {ObjectivesPatients with (SSD) present with cognitive, behavioral, and emotional difficulties. Affected individuals often exhibit poor insight into aspects of their illness, such as awareness of the illness itself or the need for treatment, which can hinder treatment adherence and complicate clinical outcomes. This study aimed to investigate the relationships between clinical symptoms and dimensions of insight in SSD using a network approach, which captures direct and indirect relationships among variables. We hypothesized that illness awareness would correlate negatively with positive symptoms and positively with depressive symptoms, and that positive symptoms would have the strongest influence on the network.MethodsData were collected from 142 individuals diagnosed with SSD. Insight was measured using the Birchwood Insight Scale (IS) across three dimensions: illness awareness, symptom re-labelling, and awareness of the need for treatment. Symptoms were evaluated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, the Calgary Depression Scale and the Hamilton Anxiety Scale. Network analysis was employed to explore interconnections (edges) between variables (nodes) and identify influential variables through centrality measures (strength, betweenness, closeness).ResultsA significant positive connection was found between illness awareness and depressive symptoms. Anxiety and depressive symptoms were identified as the most central and influential variables within the network. Treatment awareness showed greater centrality than illness awareness, indicating this dimension's potential importance in influencing symptom dynamics in a clinical profile.ConclusionsAnalyzing a more extensive network that includes treatment adherence and cognitive domains affected in SSD could enhance and validate the understanding of the cascading effects of symptoms and insight dimensions, allowing for more tailored treatments.Plain Language Summary TitleInterconnections between levels of awareness and clinical symptoms in schizophrenia and related disorders.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
ObjectivesPatients with (SSD) present with cognitive, behavioral, and emotional difficulties. Affected individuals often exhibit poor insight into aspects of their illness, such as awareness of the illness itself or the need for treatment, which can hinder treatment adherence and complicate clinical outcomes. This study aimed to investigate the relationships between clinical symptoms and dimensions of insight in SSD using a network approach, which captures direct and indirect relationships among variables. We hypothesized that illness awareness would correlate negatively with positive symptoms and positively with depressive symptoms, and that positive symptoms would have the strongest influence on the network.MethodsData were collected from 142 individuals diagnosed with SSD. Insight was measured using the Birchwood Insight Scale (IS) across three dimensions: illness awareness, symptom re-labelling, and awareness of the need for treatment. Symptoms were evaluated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, the Calgary Depression Scale and the Hamilton Anxiety Scale. Network analysis was employed to explore interconnections (edges) between variables (nodes) and identify influential variables through centrality measures (strength, betweenness, closeness).ResultsA significant positive connection was found between illness awareness and depressive symptoms. Anxiety and depressive symptoms were identified as the most central and influential variables within the network. Treatment awareness showed greater centrality than illness awareness, indicating this dimension's potential importance in influencing symptom dynamics in a clinical profile.ConclusionsAnalyzing a more extensive network that includes treatment adherence and cognitive domains affected in SSD could enhance and validate the understanding of the cascading effects of symptoms and insight dimensions, allowing for more tailored treatments.Plain Language Summary TitleInterconnections between levels of awareness and clinical symptoms in schizophrenia and related disorders.
Au-Yeung, Christy; Thai, Helen; Best, Michael; Bowie, Christopher R; Guimond, Synthia; Lavigne, Katie M; Menon, Mahesh; Moritz, Steffen; Piat, Myra; Sauvé, Geneviève; Sousa, Ana Elisa; Thibaudeau, Elisabeth; Woodward, Todd S; Lepage, Martin; Raucher-Chéné, Delphine
In: JMIR Res Protoc, vol. 14, pp. e63269, 2025, ISSN: 1929-0748.
@article{pmid40233365,
title = {iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial},
author = {Christy Au-Yeung and Helen Thai and Michael Best and Christopher R Bowie and Synthia Guimond and Katie M Lavigne and Mahesh Menon and Steffen Moritz and Myra Piat and Geneviève Sauvé and Ana Elisa Sousa and Elisabeth Thibaudeau and Todd S Woodward and Martin Lepage and Delphine Raucher-Chéné},
doi = {10.2196/63269},
issn = {1929-0748},
year = {2025},
date = {2025-04-01},
journal = {JMIR Res Protoc},
volume = {14},
pages = {e63269},
abstract = {BACKGROUND: Cognitive impairments are a key aspect of schizophrenia spectrum disorders (SSDs), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite evidence-based interventions like action-based cognitive remediation (ABCR) and metacognitive training (MCT), a research-to-practice gap exists in their application across mental health settings.nnOBJECTIVE: The iCogCA study aims to address this gap by implementing digital ABCR and MCT through a national Canadian collaborative effort using digital psychological interventions to enhance cognitive health in SSDs.nnMETHODS: The study involves 5 Canadian sites, with mental health care practitioners trained digitally through the E-Cog platform, which was developed by our research group. Over 2.5 years, participants with SSDs will undergo pre- and postintervention assessments for clinical symptoms, cognition, and functioning. Each site will run groups annually for both ABCR and MCT, totaling ~390 participants. A nonrandomized concurrent controlled design will assess effectiveness design, in which one intervention (eg, ABCR) acts as the active control for the other (eg, MCT) and vice versa, comparing cognitive and clinical outcomes between the interventions using generalized linear mixed effect modeling. Implementation strategy evaluation will consider the digital platform's efficacy for mental health care practitioners' training, contextual factors influencing implementation, and sustainability, using descriptive statistics for quantitative data and thematic analysis for qualitative data.nnRESULTS: A pilot pragmatic trial has been conducted previously at the Montreal site, evaluating 3 early implementation outcomes: acceptability, feasibility, and engagement. Patient and therapist acceptability was deemed as high and feasible (21/28, 75% of recruited service users completed therapy, rated feasible by therapists). Technology did not appear to significantly impede program participation. Therapist-rated levels of engagement were also satisfactory. In the ongoing study, recruitment is underway (114 participants recruited as of winter 2024), and intervention groups have been conducted at all sites, with therapists receiving training via the E-Cog learning platform (32 enrolled as of winter 2024).nnCONCLUSIONS: At least 3 significant innovations will stem from this project. First, this national effort represents a catalyst for the use of digital technologies to increase the adoption of evidence-based interventions and will provide important results on the effectiveness of digitally delivered ABCR and MCT. Second, the results of the implementation component of this study will generate the expertise needed to inform the implementation of similar initiatives. Third, the proposed study will introduce and validate our platform to train and supervise mental health care practitioners to deliver these interventions, which will then be made accessible to the broader mental health community.nnTRIAL REGISTRATION: ClinicalTrials.gov NCT05661448; https://clinicaltrials.gov/study/NCT05661448.nnINTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63269.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Cognitive impairments are a key aspect of schizophrenia spectrum disorders (SSDs), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite evidence-based interventions like action-based cognitive remediation (ABCR) and metacognitive training (MCT), a research-to-practice gap exists in their application across mental health settings.nnOBJECTIVE: The iCogCA study aims to address this gap by implementing digital ABCR and MCT through a national Canadian collaborative effort using digital psychological interventions to enhance cognitive health in SSDs.nnMETHODS: The study involves 5 Canadian sites, with mental health care practitioners trained digitally through the E-Cog platform, which was developed by our research group. Over 2.5 years, participants with SSDs will undergo pre- and postintervention assessments for clinical symptoms, cognition, and functioning. Each site will run groups annually for both ABCR and MCT, totaling ~390 participants. A nonrandomized concurrent controlled design will assess effectiveness design, in which one intervention (eg, ABCR) acts as the active control for the other (eg, MCT) and vice versa, comparing cognitive and clinical outcomes between the interventions using generalized linear mixed effect modeling. Implementation strategy evaluation will consider the digital platform's efficacy for mental health care practitioners' training, contextual factors influencing implementation, and sustainability, using descriptive statistics for quantitative data and thematic analysis for qualitative data.nnRESULTS: A pilot pragmatic trial has been conducted previously at the Montreal site, evaluating 3 early implementation outcomes: acceptability, feasibility, and engagement. Patient and therapist acceptability was deemed as high and feasible (21/28, 75% of recruited service users completed therapy, rated feasible by therapists). Technology did not appear to significantly impede program participation. Therapist-rated levels of engagement were also satisfactory. In the ongoing study, recruitment is underway (114 participants recruited as of winter 2024), and intervention groups have been conducted at all sites, with therapists receiving training via the E-Cog learning platform (32 enrolled as of winter 2024).nnCONCLUSIONS: At least 3 significant innovations will stem from this project. First, this national effort represents a catalyst for the use of digital technologies to increase the adoption of evidence-based interventions and will provide important results on the effectiveness of digitally delivered ABCR and MCT. Second, the results of the implementation component of this study will generate the expertise needed to inform the implementation of similar initiatives. Third, the proposed study will introduce and validate our platform to train and supervise mental health care practitioners to deliver these interventions, which will then be made accessible to the broader mental health community.nnTRIAL REGISTRATION: ClinicalTrials.gov NCT05661448; https://clinicaltrials.gov/study/NCT05661448.nnINTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63269.
Dupont, Logane; Raucher-Chéné, Delphine; Mercier, Novembre; Demers, Gabriel; Wang, Michelle; Beauchamp, Philippe; Lepage, Martin; Thibaudeau, Elisabeth
In: Psychiatr Rehabil J, 2025, ISSN: 1559-3126.
@article{pmid40310207,
title = {Digital travel using virtual reality in inpatient psychiatric care: Focus group exploration of perspectives from individuals with lived experience},
author = {Logane Dupont and Delphine Raucher-Chéné and Novembre Mercier and Gabriel Demers and Michelle Wang and Philippe Beauchamp and Martin Lepage and Elisabeth Thibaudeau},
doi = {10.1037/prj0000646},
issn = {1559-3126},
year = {2025},
date = {2025-04-01},
journal = {Psychiatr Rehabil J},
abstract = {OBJECTIVE: Hospitalization in psychiatry is a challenging experience associated with increased levels of distress, anxiety, and loneliness. Novel technologies are being developed to help alleviate these symptoms and support the treatment and rehabilitation of these individuals. This study aims to explore the perspectives of individuals with lived experience of a complex mood disorder on the proposal of an immersive virtual reality (VR) travel-in-nature application with a social feature being an available service in a psychiatric inpatient unit.nnMETHODS: A thematic analysis was performed with data acquired from two focus group semistructured interviews conducted by a patient partner with individuals currently hospitalized in a short-term inpatient unit dedicated to complex mood disorders.nnRESULTS: Three themes were generated from the thematic analysis: (a) factors enhancing acceptability, (b) barriers, and (c) envisioning the future of the application and VR in inpatient mental health.nnCONCLUSIONS: Participants were largely positive regarding the potential of the application and VR in psychiatric inpatient care. They viewed it as a promising rehabilitation tool for relaxation and positive escapism. Concerns regarding suitability, potential risks associated with the technology, and technical barriers were raised and warrant further investigation.nnIMPLICATIONS FOR PRACTICE: This study's preliminary findings offer relevant information for designing the implementation process of VR in psychiatric inpatient units, with the intent of tailoring services to the needs and realities of their intended users. (PsycInfo Database Record (c) 2025 APA, all rights reserved).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Hospitalization in psychiatry is a challenging experience associated with increased levels of distress, anxiety, and loneliness. Novel technologies are being developed to help alleviate these symptoms and support the treatment and rehabilitation of these individuals. This study aims to explore the perspectives of individuals with lived experience of a complex mood disorder on the proposal of an immersive virtual reality (VR) travel-in-nature application with a social feature being an available service in a psychiatric inpatient unit.nnMETHODS: A thematic analysis was performed with data acquired from two focus group semistructured interviews conducted by a patient partner with individuals currently hospitalized in a short-term inpatient unit dedicated to complex mood disorders.nnRESULTS: Three themes were generated from the thematic analysis: (a) factors enhancing acceptability, (b) barriers, and (c) envisioning the future of the application and VR in inpatient mental health.nnCONCLUSIONS: Participants were largely positive regarding the potential of the application and VR in psychiatric inpatient care. They viewed it as a promising rehabilitation tool for relaxation and positive escapism. Concerns regarding suitability, potential risks associated with the technology, and technical barriers were raised and warrant further investigation.nnIMPLICATIONS FOR PRACTICE: This study's preliminary findings offer relevant information for designing the implementation process of VR in psychiatric inpatient units, with the intent of tailoring services to the needs and realities of their intended users. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Ghanem, Joseph; Totzek, Jana F; Henri-Bellemare, Charlie; Raucher-Chéné, Delphine; Kiar, Gregory; Patel, Raihaan; Chakravarty, M Mallar; Shah, Jai L; Joober, Ridha; Malla, Ashok; Lepage, Martin; Lavigne, Katie M
White matter integrity and verbal memory following a first episode of psychosis: A longitudinal study Journal Article
In: Prog Neuropsychopharmacol Biol Psychiatry, vol. 137, pp. 111294, 2025, ISSN: 1878-4216.
@article{pmid39986368,
title = {White matter integrity and verbal memory following a first episode of psychosis: A longitudinal study},
author = {Joseph Ghanem and Jana F Totzek and Charlie Henri-Bellemare and Delphine Raucher-Chéné and Gregory Kiar and Raihaan Patel and M Mallar Chakravarty and Jai L Shah and Ridha Joober and Ashok Malla and Martin Lepage and Katie M Lavigne},
doi = {10.1016/j.pnpbp.2025.111294},
issn = {1878-4216},
year = {2025},
date = {2025-03-01},
journal = {Prog Neuropsychopharmacol Biol Psychiatry},
volume = {137},
pages = {111294},
abstract = {Psychotic disorders are heterogeneous disorders for which there is evidence of structural and functional brain abnormalities. The role of white matter integrity, often measured via Fractional Anisotropy (FA), has played a controversial role in individuals with a first episode of psychosis (FEP). Similarly, some FEP studies have observed that higher FA is associated with better verbal memory, but others failed to find such an association. Studying the early stages of psychosis represents a promising avenue to overcome previous confounding factors and characterize the disease in its early clinical stages. Eighty individuals with a FEP were recruited from a specialized early intervention program for psychosis alongside 55 non-clinical controls from the community matched for age and sex. Both groups were followed and scanned 4 times: at baseline (within 3 months after program entry), 6 months, 12 months, and 18 months. Tract-Based Spatial Statistics (TBSS) were used on 3.0 Tesla diffusion-weighted images to extract fractional anisotropy values for white matter regions of interest in accordance with the John Hopkins University white-matter tractography atlas. The analysis revealed no significant main effect of group or time, and no significant associations between FA and verbal memory. Overall, differences in FA are small early in the course of illness and longer follow-up periods may be required to identify possible changes during a critical intervention window.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Psychotic disorders are heterogeneous disorders for which there is evidence of structural and functional brain abnormalities. The role of white matter integrity, often measured via Fractional Anisotropy (FA), has played a controversial role in individuals with a first episode of psychosis (FEP). Similarly, some FEP studies have observed that higher FA is associated with better verbal memory, but others failed to find such an association. Studying the early stages of psychosis represents a promising avenue to overcome previous confounding factors and characterize the disease in its early clinical stages. Eighty individuals with a FEP were recruited from a specialized early intervention program for psychosis alongside 55 non-clinical controls from the community matched for age and sex. Both groups were followed and scanned 4 times: at baseline (within 3 months after program entry), 6 months, 12 months, and 18 months. Tract-Based Spatial Statistics (TBSS) were used on 3.0 Tesla diffusion-weighted images to extract fractional anisotropy values for white matter regions of interest in accordance with the John Hopkins University white-matter tractography atlas. The analysis revealed no significant main effect of group or time, and no significant associations between FA and verbal memory. Overall, differences in FA are small early in the course of illness and longer follow-up periods may be required to identify possible changes during a critical intervention window.
Sousa, Ana Elisa; Dakoure, Caroline; Au-Yeung, Christy; Lavigne, Katie M; Raucher-Chéné, Delphine; Bowie, Christopher R; Moritz, Steffen; Lepage, Martin; Sauvé, Geneviève
E-Cog: An online training platform for cognitive health interventions based on the ADDIE model Journal Article
In: Digit Health, vol. 11, pp. 20552076251381249, 2025, ISSN: 2055-2076.
@article{pmid41116811,
title = {E-Cog: An online training platform for cognitive health interventions based on the ADDIE model},
author = {Ana Elisa Sousa and Caroline Dakoure and Christy Au-Yeung and Katie M Lavigne and Delphine Raucher-Chéné and Christopher R Bowie and Steffen Moritz and Martin Lepage and Geneviève Sauvé},
doi = {10.1177/20552076251381249},
issn = {2055-2076},
year = {2025},
date = {2025-01-01},
journal = {Digit Health},
volume = {11},
pages = {20552076251381249},
abstract = {BACKGROUND: Online learning is an accessible and cost-effective solution to deliver training in healthcare. In-person training has long supported mental health practitioners in delivering cognitive health interventions, however for many underserved populations, significant barriers to accessing standardized, evidence-based training for such treatments remain. The E-Cog platform aims to bridge this implementation gap, delivering accessible and engaging remote training that maintains the quality of in-person training.nnOBJECTIVES: Describe the design, development, and implementation of E-Cog, an innovative online training platform for two cognitive health interventions, within the context of a Canadian multisite implementation trial for individuals diagnosed with psychosis. Additionally, examine the feasibility and acceptability of the ADDIE educational framework for e-learning development.nnMETHODS: Following the ADDIE model's five phases (analysis, design, development, implementation, and evaluation), we developed our training platform and its curriculum of two cognitive health online certifications: Action-Based Cognitive Remediation and Metacognitive Training. This protocol describes the first four phases of our work and reports on the feasibility and acceptability of the ADDIE model.nnCONCLUSIONS: E-Cog has been implemented to deliver remote, asynchronous training that maintains in-person quality standards and shows potential for cost-effectiveness. Successful uptake of mental health practitioners ( = 28) was observed during the first two years of implementation. ADDIE was perceived as feasible and acceptable as a framework for e-learning content, depending on flexibility to adapt its structure to research challenges and constraints. Next steps include a qualitative assessment of E-Cog's usability and impact on intervention delivery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Online learning is an accessible and cost-effective solution to deliver training in healthcare. In-person training has long supported mental health practitioners in delivering cognitive health interventions, however for many underserved populations, significant barriers to accessing standardized, evidence-based training for such treatments remain. The E-Cog platform aims to bridge this implementation gap, delivering accessible and engaging remote training that maintains the quality of in-person training.nnOBJECTIVES: Describe the design, development, and implementation of E-Cog, an innovative online training platform for two cognitive health interventions, within the context of a Canadian multisite implementation trial for individuals diagnosed with psychosis. Additionally, examine the feasibility and acceptability of the ADDIE educational framework for e-learning development.nnMETHODS: Following the ADDIE model's five phases (analysis, design, development, implementation, and evaluation), we developed our training platform and its curriculum of two cognitive health online certifications: Action-Based Cognitive Remediation and Metacognitive Training. This protocol describes the first four phases of our work and reports on the feasibility and acceptability of the ADDIE model.nnCONCLUSIONS: E-Cog has been implemented to deliver remote, asynchronous training that maintains in-person quality standards and shows potential for cost-effectiveness. Successful uptake of mental health practitioners ( = 28) was observed during the first two years of implementation. ADDIE was perceived as feasible and acceptable as a framework for e-learning content, depending on flexibility to adapt its structure to research challenges and constraints. Next steps include a qualitative assessment of E-Cog's usability and impact on intervention delivery.
2024
Totzek, Jana F; Chakravarty, M Mallar; Joober, Ridha; Malla, Ashok; Shah, Jai L; Raucher-Chéné, Delphine; Young, Alexandra L; Hernaus, Dennis; Lepage, Martin; Lavigne, Katie M
Longitudinal inference of multiscale markers in psychosis: from hippocampal centrality to functional outcome Journal Article
In: Mol Psychiatry, vol. 29, no. 10, pp. 2929–2938, 2024, ISSN: 1476-5578.
@article{pmid38605172,
title = {Longitudinal inference of multiscale markers in psychosis: from hippocampal centrality to functional outcome},
author = {Jana F Totzek and M Mallar Chakravarty and Ridha Joober and Ashok Malla and Jai L Shah and Delphine Raucher-Chéné and Alexandra L Young and Dennis Hernaus and Martin Lepage and Katie M Lavigne},
doi = {10.1038/s41380-024-02549-x},
issn = {1476-5578},
year = {2024},
date = {2024-10-01},
journal = {Mol Psychiatry},
volume = {29},
number = {10},
pages = {2929--2938},
abstract = {Multiscale neuroscience conceptualizes mental illness as arising from aberrant interactions across and within multiple biopsychosocial scales. We leverage this framework to propose a multiscale disease progression model of psychosis, in which hippocampal-cortical dysconnectivity precedes impairments in episodic memory and social cognition, which lead to more severe negative symptoms and lower functional outcome. As psychosis represents a heterogeneous collection of biological and behavioral alterations that evolve over time, we further predict this disease progression for a subtype of the patient sample, with other patients showing normal-range performance on all variables. We sampled data from two cross-sectional datasets of first- and multi-episode psychosis, resulting in a sample of 163 patients and 119 non-clinical controls. To address our proposed disease progression model and evaluate potential heterogeneity, we applied a machine-learning algorithm, SuStaIn, to the patient data. SuStaIn uniquely integrates clustering and disease progression modeling and identified three patient subtypes. Subtype 0 showed normal-range performance on all variables. In comparison, Subtype 1 showed lower episodic memory, social cognition, functional outcome, and higher negative symptoms, while Subtype 2 showed lower hippocampal-cortical connectivity and episodic memory. Subtype 1 deteriorated from episodic memory to social cognition, negative symptoms, functional outcome to bilateral hippocampal-cortical dysconnectivity, while Subtype 2 deteriorated from bilateral hippocampal-cortical dysconnectivity to episodic memory and social cognition, functional outcome to negative symptoms. This first application of SuStaIn in a multiscale psychiatric model provides distinct disease trajectories of hippocampal-cortical connectivity, which might underlie the heterogeneous behavioral manifestations of psychosis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Multiscale neuroscience conceptualizes mental illness as arising from aberrant interactions across and within multiple biopsychosocial scales. We leverage this framework to propose a multiscale disease progression model of psychosis, in which hippocampal-cortical dysconnectivity precedes impairments in episodic memory and social cognition, which lead to more severe negative symptoms and lower functional outcome. As psychosis represents a heterogeneous collection of biological and behavioral alterations that evolve over time, we further predict this disease progression for a subtype of the patient sample, with other patients showing normal-range performance on all variables. We sampled data from two cross-sectional datasets of first- and multi-episode psychosis, resulting in a sample of 163 patients and 119 non-clinical controls. To address our proposed disease progression model and evaluate potential heterogeneity, we applied a machine-learning algorithm, SuStaIn, to the patient data. SuStaIn uniquely integrates clustering and disease progression modeling and identified three patient subtypes. Subtype 0 showed normal-range performance on all variables. In comparison, Subtype 1 showed lower episodic memory, social cognition, functional outcome, and higher negative symptoms, while Subtype 2 showed lower hippocampal-cortical connectivity and episodic memory. Subtype 1 deteriorated from episodic memory to social cognition, negative symptoms, functional outcome to bilateral hippocampal-cortical dysconnectivity, while Subtype 2 deteriorated from bilateral hippocampal-cortical dysconnectivity to episodic memory and social cognition, functional outcome to negative symptoms. This first application of SuStaIn in a multiscale psychiatric model provides distinct disease trajectories of hippocampal-cortical connectivity, which might underlie the heterogeneous behavioral manifestations of psychosis.
Lavigne, Katie M; Deng, Jiaxuan; Raucher-Chéné, Delphine; Hotte-Meunier, Adèle; Voyer, Chloe; Sarraf, Lisa; Lepage, Martin; Sauvé, Geneviève
Transdiagnostic cognitive biases in psychiatric disorders: A systematic review and network meta-analysis Journal Article
In: Prog Neuropsychopharmacol Biol Psychiatry, vol. 129, pp. 110894, 2024, ISSN: 1878-4216.
@article{pmid37956787,
title = {Transdiagnostic cognitive biases in psychiatric disorders: A systematic review and network meta-analysis},
author = {Katie M Lavigne and Jiaxuan Deng and Delphine Raucher-Chéné and Adèle Hotte-Meunier and Chloe Voyer and Lisa Sarraf and Martin Lepage and Geneviève Sauvé},
doi = {10.1016/j.pnpbp.2023.110894},
issn = {1878-4216},
year = {2024},
date = {2024-02-01},
journal = {Prog Neuropsychopharmacol Biol Psychiatry},
volume = {129},
pages = {110894},
abstract = {Psychiatric disorders are characterized by cognitive deficits, which have been proposed as a transdiagnostic feature of psychopathology ("C" factor). Similarly, cognitive biases (e.g., in attention, memory, and interpretation) represent common tendencies in information processing that are often associated with psychiatric symptoms. However, the question remains whether cognitive biases are also transdiagnostic or are specific to certain psychiatric disorders/symptoms. The current systematic review sought to address whether the proposed "C" factor of transdiagnostic cognitive dysfunction in psychopathology can be extended to cognitive biases. Overall, 31 studies comprising 4401 participants (2536 patients, 1865 non-clinical controls) met inclusion criteria, assessing 19 cognitive biases across 20 diagnostic categories, with most studies focusing on interpretation (k = 22) and attention (k = 11) biases and only 2 assessing memory biases. Traditional meta-analyses found a moderate effect size (g = 0.32) for more severe cognitive biases in all patients relative to non-clinical controls, as well as small but significant associations between interpretation biases and transdiagnostic symptom categories (general psychopathology: r = 0.20, emotion dysfunction: r = 0.17, psychotic symptoms: r = 0.25). Network meta-analyses revealed significant patient versus non-clinical control differences on attention and interpretation biases across diagnoses, as well as significant differences between diagnoses, with highest severity in panic disorder for attention biases and obsessive-compulsive disorder for interpretation biases. The current findings extend the big "C" interpretation of transdiagnostic cognitive dysfunction in psychiatric disorders to cognitive biases and transdiagnostic symptom dimensions. Results also suggest that while the presence of cognitive biases is transdiagnostic, bias severity differs across diagnoses, as in traditional neurocognitive deficits.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Psychiatric disorders are characterized by cognitive deficits, which have been proposed as a transdiagnostic feature of psychopathology ("C" factor). Similarly, cognitive biases (e.g., in attention, memory, and interpretation) represent common tendencies in information processing that are often associated with psychiatric symptoms. However, the question remains whether cognitive biases are also transdiagnostic or are specific to certain psychiatric disorders/symptoms. The current systematic review sought to address whether the proposed "C" factor of transdiagnostic cognitive dysfunction in psychopathology can be extended to cognitive biases. Overall, 31 studies comprising 4401 participants (2536 patients, 1865 non-clinical controls) met inclusion criteria, assessing 19 cognitive biases across 20 diagnostic categories, with most studies focusing on interpretation (k = 22) and attention (k = 11) biases and only 2 assessing memory biases. Traditional meta-analyses found a moderate effect size (g = 0.32) for more severe cognitive biases in all patients relative to non-clinical controls, as well as small but significant associations between interpretation biases and transdiagnostic symptom categories (general psychopathology: r = 0.20, emotion dysfunction: r = 0.17, psychotic symptoms: r = 0.25). Network meta-analyses revealed significant patient versus non-clinical control differences on attention and interpretation biases across diagnoses, as well as significant differences between diagnoses, with highest severity in panic disorder for attention biases and obsessive-compulsive disorder for interpretation biases. The current findings extend the big "C" interpretation of transdiagnostic cognitive dysfunction in psychiatric disorders to cognitive biases and transdiagnostic symptom dimensions. Results also suggest that while the presence of cognitive biases is transdiagnostic, bias severity differs across diagnoses, as in traditional neurocognitive deficits.
2023
Ghanem, Joseph; Orri, Massimiliano; Moro, Laura; Lavigne, Katie M; Raucher-Chéné, Delphine; Malla, Ashok; Joober, Ridha; Lepage, Martin
Exploring the Relationship Between Suicidality and Persistent Negative Symptoms Following a First Episode of Psychosis Journal Article
In: Schizophr Bull, 2023, ISSN: 1745-1701.
@article{pmid37847817,
title = {Exploring the Relationship Between Suicidality and Persistent Negative Symptoms Following a First Episode of Psychosis},
author = {Joseph Ghanem and Massimiliano Orri and Laura Moro and Katie M Lavigne and Delphine Raucher-Chéné and Ashok Malla and Ridha Joober and Martin Lepage},
doi = {10.1093/schbul/sbad146},
issn = {1745-1701},
year = {2023},
date = {2023-10-01},
journal = {Schizophr Bull},
abstract = {BACKGROUND AND HYPOTHESIS: Suicide is a leading cause of death in first-episode psychosis (FEP), with an elevated risk during the first year following illness onset. The association between negative symptoms and suicidality remains contentious. Some studies suggest that negative symptoms may be associated with lower suicidality, while others fail to find an association between the two. No previous studies have specifically investigated suicidality in Persistent Negative Symptoms (PNS) and its associated subgroups.nnSTUDY DESIGN: In a large cohort of FEP patients (n = 515) from an early intervention service, we investigated suicidality in those with PNS, secondary PNS (ie, sPNS; PNS with clinical-level positive, depressive, or extrapyramidal symptoms), and non-PNS (all other patients) over 24 months. Patients were categorized into PNS groups based on symptoms from month 6 to month 12, and suicidality was evaluated using the Brief Psychiatric Rating Scale (BPRS).nnSTUDY RESULTS: Covarying for age and sex, we found that sPNS had higher suicidality relative to PNS and non-PNS throughout the 24-month period, but PNS and non-PNS did not differ. These differences were maintained after adjusting for depressive symptoms.nnCONCLUSION: We observed that PNS did not significantly differ from non-PNS. However, we identified sPNS as a group with elevated suicidality above and beyond depression, suggesting that sPNS would benefit from targeted intervention and that PNS categorization identifies a subgroup for whom negative symptoms are not associated with lower suicidality.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND AND HYPOTHESIS: Suicide is a leading cause of death in first-episode psychosis (FEP), with an elevated risk during the first year following illness onset. The association between negative symptoms and suicidality remains contentious. Some studies suggest that negative symptoms may be associated with lower suicidality, while others fail to find an association between the two. No previous studies have specifically investigated suicidality in Persistent Negative Symptoms (PNS) and its associated subgroups.nnSTUDY DESIGN: In a large cohort of FEP patients (n = 515) from an early intervention service, we investigated suicidality in those with PNS, secondary PNS (ie, sPNS; PNS with clinical-level positive, depressive, or extrapyramidal symptoms), and non-PNS (all other patients) over 24 months. Patients were categorized into PNS groups based on symptoms from month 6 to month 12, and suicidality was evaluated using the Brief Psychiatric Rating Scale (BPRS).nnSTUDY RESULTS: Covarying for age and sex, we found that sPNS had higher suicidality relative to PNS and non-PNS throughout the 24-month period, but PNS and non-PNS did not differ. These differences were maintained after adjusting for depressive symptoms.nnCONCLUSION: We observed that PNS did not significantly differ from non-PNS. However, we identified sPNS as a group with elevated suicidality above and beyond depression, suggesting that sPNS would benefit from targeted intervention and that PNS categorization identifies a subgroup for whom negative symptoms are not associated with lower suicidality.
du Sert, Olivier Percie; Unrau, Joshua; Gauthier, Claudine J; Chakravarty, Mallar; Malla, Ashok; Lepage, Martin; Raucher-Chéné, Delphine
Cerebral blood flow in schizophrenia: A systematic review and meta-analysis of MRI-based studies Journal Article
In: Prog Neuropsychopharmacol Biol Psychiatry, vol. 121, pp. 110669, 2023, ISSN: 1878-4216.
@article{pmid36341843,
title = {Cerebral blood flow in schizophrenia: A systematic review and meta-analysis of MRI-based studies},
author = {Olivier Percie du Sert and Joshua Unrau and Claudine J Gauthier and Mallar Chakravarty and Ashok Malla and Martin Lepage and Delphine Raucher-Chéné},
doi = {10.1016/j.pnpbp.2022.110669},
issn = {1878-4216},
year = {2023},
date = {2023-03-01},
journal = {Prog Neuropsychopharmacol Biol Psychiatry},
volume = {121},
pages = {110669},
abstract = {INTRODUCTION: Schizophrenia-spectrum disorders (SSD) represent one of the leading causes of disability worldwide and are usually underpinned by neurodevelopmental brain abnormalities observed on a structural and functional level. Nuclear medicine imaging studies of cerebral blood flow (CBF) have already provided insights into the pathophysiology of these disorders. Recent developments in non-invasive MRI techniques such as arterial spin labeling (ASL) have allowed broader examination of CBF across SSD prompting us to conduct an updated literature review of MRI-based perfusion studies. In addition, we conducted a focused meta-analysis of whole brain studies to provide a complete picture of the literature on the topic.nnMETHODS: A systematic OVID search was performed in Embase, MEDLINEOvid, and PsycINFO. Studies eligible for inclusion in the review involved: 1) individuals with SSD, first-episode psychosis or clinical-high risk for psychosis, or; 2) had healthy controls for comparison; 3) involved MRI-based perfusion imaging methods; and 4) reported CBF findings. No time span was specified for the database queries (last search: 08/2022). Information related to participants, MRI techniques, CBF analyses, and results were systematically extracted. Whole-brain studies were then selected for the meta-analysis procedure. The methodological quality of each included studies was assessed.nnRESULTS: For the systematic review, the initial Ovid search yielded 648 publications of which 42 articles were included, representing 3480 SSD patients and controls. The most consistent finding was that negative symptoms were linked to cortical fronto-limbic hypoperfusion while positive symptoms seemed to be associated with hyperperfusion, notably in subcortical structures. The meta-analysis integrated results from 13 whole-brain studies, across 426 patients and 401 controls, and confirmed the robustness of the hypoperfusion in the left superior and middle frontal gyri and right middle occipital gyrus while hyperperfusion was found in the left putamen.nnCONCLUSION: This updated review of the literature supports the implication of hemodynamic correlates in the pathophysiology of psychosis symptoms and disorders. A more systematic exploration of brain perfusion could complete the search of a multimodal biomarker of SSD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Schizophrenia-spectrum disorders (SSD) represent one of the leading causes of disability worldwide and are usually underpinned by neurodevelopmental brain abnormalities observed on a structural and functional level. Nuclear medicine imaging studies of cerebral blood flow (CBF) have already provided insights into the pathophysiology of these disorders. Recent developments in non-invasive MRI techniques such as arterial spin labeling (ASL) have allowed broader examination of CBF across SSD prompting us to conduct an updated literature review of MRI-based perfusion studies. In addition, we conducted a focused meta-analysis of whole brain studies to provide a complete picture of the literature on the topic.nnMETHODS: A systematic OVID search was performed in Embase, MEDLINEOvid, and PsycINFO. Studies eligible for inclusion in the review involved: 1) individuals with SSD, first-episode psychosis or clinical-high risk for psychosis, or; 2) had healthy controls for comparison; 3) involved MRI-based perfusion imaging methods; and 4) reported CBF findings. No time span was specified for the database queries (last search: 08/2022). Information related to participants, MRI techniques, CBF analyses, and results were systematically extracted. Whole-brain studies were then selected for the meta-analysis procedure. The methodological quality of each included studies was assessed.nnRESULTS: For the systematic review, the initial Ovid search yielded 648 publications of which 42 articles were included, representing 3480 SSD patients and controls. The most consistent finding was that negative symptoms were linked to cortical fronto-limbic hypoperfusion while positive symptoms seemed to be associated with hyperperfusion, notably in subcortical structures. The meta-analysis integrated results from 13 whole-brain studies, across 426 patients and 401 controls, and confirmed the robustness of the hypoperfusion in the left superior and middle frontal gyri and right middle occipital gyrus while hyperperfusion was found in the left putamen.nnCONCLUSION: This updated review of the literature supports the implication of hemodynamic correlates in the pathophysiology of psychosis symptoms and disorders. A more systematic exploration of brain perfusion could complete the search of a multimodal biomarker of SSD.
Thibaudeau, Elisabeth; Rae, Jesse; Raucher-Chéné, Delphine; Bougeard, Alan; Lepage, Martin
Disentangling the Relationships Between the Clinical Symptoms of Schizophrenia Spectrum Disorders and Theory of Mind: A Meta-analysis Journal Article
In: Schizophr Bull, vol. 49, no. 2, pp. 255–274, 2023, ISSN: 1745-1701.
@article{pmid36244001,
title = {Disentangling the Relationships Between the Clinical Symptoms of Schizophrenia Spectrum Disorders and Theory of Mind: A Meta-analysis},
author = {Elisabeth Thibaudeau and Jesse Rae and Delphine Raucher-Chéné and Alan Bougeard and Martin Lepage},
doi = {10.1093/schbul/sbac150},
issn = {1745-1701},
year = {2023},
date = {2023-03-01},
journal = {Schizophr Bull},
volume = {49},
number = {2},
pages = {255--274},
abstract = {BACKGROUND AND HYPOTHESIS: Previous studies have suggested links between clinical symptoms and theory of mind (ToM) impairments in schizophrenia spectrum disorders (SSD), but it remains unclear whether some symptoms are more strongly linked to ToM than others.nnSTUDY DESIGN: A meta-analysis (Prospero; CRD42021259723) was conducted to quantify and compare the strength of the associations between ToM and the clinical symptoms of SSD (Positive, Negative, Cognitive/Disorganization, Depression/Anxiety, Excitability/Hostility). Studies (N = 130, 137 samples) including people with SSD and reporting a correlation between clinical symptoms and ToM were retrieved from Pubmed, PsycNet, Embase, Cochrane Library, Science Direct, Proquest, WorldCat, and Open Gray. Correlations for each dimension and each symptom were entered into a random-effect model using a Fisher's r-to-z transformation and were compared using focused-tests. Publication bias was assessed with the Rosenthal failsafe and by inspecting the funnel plot and the standardized residual histogram.nnSTUDY RESULTS: The Cognitive/Disorganization (Zr = 0.28) and Negative (Zr = 0.24) dimensions revealed a small to moderate association with ToM, which was significantly stronger than the other dimensions. Within the Cognitive/Disorganization dimension, Difficulty in abstract thinking (Zr = 0.36) and Conceptual disorganization (Zr = 0.39) showed the strongest associations with ToM. The association with the Positive dimension (Zr = 0.16) was small and significantly stronger than the relationship with Depression/Anxiety (Zr = 0.09). Stronger associations were observed between ToM and clinical symptoms in younger patients, those with an earlier age at onset of illness and for tasks assessing a combination of different mental states.nnCONCLUSIONS: The relationships between Cognitive/Disorganization, Negative symptoms, and ToM should be considered in treating individuals with SSD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND AND HYPOTHESIS: Previous studies have suggested links between clinical symptoms and theory of mind (ToM) impairments in schizophrenia spectrum disorders (SSD), but it remains unclear whether some symptoms are more strongly linked to ToM than others.nnSTUDY DESIGN: A meta-analysis (Prospero; CRD42021259723) was conducted to quantify and compare the strength of the associations between ToM and the clinical symptoms of SSD (Positive, Negative, Cognitive/Disorganization, Depression/Anxiety, Excitability/Hostility). Studies (N = 130, 137 samples) including people with SSD and reporting a correlation between clinical symptoms and ToM were retrieved from Pubmed, PsycNet, Embase, Cochrane Library, Science Direct, Proquest, WorldCat, and Open Gray. Correlations for each dimension and each symptom were entered into a random-effect model using a Fisher's r-to-z transformation and were compared using focused-tests. Publication bias was assessed with the Rosenthal failsafe and by inspecting the funnel plot and the standardized residual histogram.nnSTUDY RESULTS: The Cognitive/Disorganization (Zr = 0.28) and Negative (Zr = 0.24) dimensions revealed a small to moderate association with ToM, which was significantly stronger than the other dimensions. Within the Cognitive/Disorganization dimension, Difficulty in abstract thinking (Zr = 0.36) and Conceptual disorganization (Zr = 0.39) showed the strongest associations with ToM. The association with the Positive dimension (Zr = 0.16) was small and significantly stronger than the relationship with Depression/Anxiety (Zr = 0.09). Stronger associations were observed between ToM and clinical symptoms in younger patients, those with an earlier age at onset of illness and for tasks assessing a combination of different mental states.nnCONCLUSIONS: The relationships between Cognitive/Disorganization, Negative symptoms, and ToM should be considered in treating individuals with SSD.
Raucher-Chéné, Delphine; Lavigne, Katie M; Lepage, Martin
Episodic Memory and Schizophrenia: From Characterization of Relational Memory Impairments to Neuroimaging Biomarkers Journal Article
In: Curr Top Behav Neurosci, vol. 63, pp. 115–136, 2023, ISSN: 1866-3370.
@article{pmid35902545,
title = {Episodic Memory and Schizophrenia: From Characterization of Relational Memory Impairments to Neuroimaging Biomarkers},
author = {Delphine Raucher-Chéné and Katie M Lavigne and Martin Lepage},
doi = {10.1007/7854_2022_379},
issn = {1866-3370},
year = {2023},
date = {2023-01-01},
journal = {Curr Top Behav Neurosci},
volume = {63},
pages = {115--136},
abstract = {Episodic memory research in schizophrenia has a long history already which has clearly established significant impairments and strong associations with brain measures and functional outcome. The purpose of this chapter is not to make an exhaustive review of the recent literature but to highlight some relatively recent developments in the cognitive neuroscience field of episodic memory and schizophrenia. Hence, we present a contemporary view focusing specifically of relational memory which represents a form of episodic memory that refers to associations or binding among items or elements presented together. We describe the major tasks used and illustrate how their combination with brain imaging has: (1) favored the use of experimental memory tasks to isolate specific processes with specific neural correlates, (2) led to a distributed view of the neural correlates of memory impairments in schizophrenia where multiple regions are contributing, and (3) made possible the identification of fMRI biomarkers specific to episodic memory. We then briefly propose what we see as the next steps for memory research in schizophrenia so that the impact of this work can be maximized.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Episodic memory research in schizophrenia has a long history already which has clearly established significant impairments and strong associations with brain measures and functional outcome. The purpose of this chapter is not to make an exhaustive review of the recent literature but to highlight some relatively recent developments in the cognitive neuroscience field of episodic memory and schizophrenia. Hence, we present a contemporary view focusing specifically of relational memory which represents a form of episodic memory that refers to associations or binding among items or elements presented together. We describe the major tasks used and illustrate how their combination with brain imaging has: (1) favored the use of experimental memory tasks to isolate specific processes with specific neural correlates, (2) led to a distributed view of the neural correlates of memory impairments in schizophrenia where multiple regions are contributing, and (3) made possible the identification of fMRI biomarkers specific to episodic memory. We then briefly propose what we see as the next steps for memory research in schizophrenia so that the impact of this work can be maximized.
2022
Unrau, Joshua; du Sert, Olivier Percie; Joober, Ridha; Malla, Ashok; Lepage, Martin; Raucher-Chéné, Delphine
Subtyping negative symptoms in first-episode psychosis: Contrasting persistent negative symptoms with a data-driven approach Journal Article
In: Schizophr Res, vol. 248, pp. 219–227, 2022, ISSN: 1573-2509.
@article{pmid36108466,
title = {Subtyping negative symptoms in first-episode psychosis: Contrasting persistent negative symptoms with a data-driven approach},
author = {Joshua Unrau and Olivier Percie du Sert and Ridha Joober and Ashok Malla and Martin Lepage and Delphine Raucher-Chéné},
doi = {10.1016/j.schres.2022.09.010},
issn = {1573-2509},
year = {2022},
date = {2022-10-01},
journal = {Schizophr Res},
volume = {248},
pages = {219--227},
abstract = {Persistent negative symptoms (PNS) are linked to poor functional outcomes and may be primary or caused by secondary factors. Although several studies have examined PNS in first-episode psychosis (FEP), a comparison with a data-driven approach is lacking. Here, we compared clinically defined PNS subgroups with class trajectories identified through latent growth modeling (LGM). Patients admitted to an early intervention service (N = 392) were classified as PNS (n = 105), secondary PNS (sPNS; n = 74), or non-PNS (n = 213) based on longitudinal data collected six to twelve months after admission. LGM was used to stratify patients based on similar negative symptom course over the same time period. Using multiple linear regression, we assessed the utility of both approaches in predicting Social and Occupational Functioning Assessment Scale (SOFAS) scores at two-year follow-up. Three negative symptom trajectories were identified: low and remitting (LR; n = 158), moderate and improving (MI; n = 163) and delayed partial response (DR; n = 71). Most non-PNS patients followed the LR trajectory, while patients with PNS or sPNS were generally divided between MI and DR. Both PNS classification and trajectory membership were significant predictors of two-year functional outcomes; the DR and MI trajectories predicted greater increases in SOFAS scores (DR: b = -19.14; MI: b = -11.54) than either sPNS (b = -9.19) or PNS (b = -6.46). These findings demonstrate that combining PNS and symptom-based stratification can predict functional outcomes more accurately than either taxonomy alone. Such a combined approach could yield significant advances in developing more targeted interventions for patients at risk for poor functional outcomes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Persistent negative symptoms (PNS) are linked to poor functional outcomes and may be primary or caused by secondary factors. Although several studies have examined PNS in first-episode psychosis (FEP), a comparison with a data-driven approach is lacking. Here, we compared clinically defined PNS subgroups with class trajectories identified through latent growth modeling (LGM). Patients admitted to an early intervention service (N = 392) were classified as PNS (n = 105), secondary PNS (sPNS; n = 74), or non-PNS (n = 213) based on longitudinal data collected six to twelve months after admission. LGM was used to stratify patients based on similar negative symptom course over the same time period. Using multiple linear regression, we assessed the utility of both approaches in predicting Social and Occupational Functioning Assessment Scale (SOFAS) scores at two-year follow-up. Three negative symptom trajectories were identified: low and remitting (LR; n = 158), moderate and improving (MI; n = 163) and delayed partial response (DR; n = 71). Most non-PNS patients followed the LR trajectory, while patients with PNS or sPNS were generally divided between MI and DR. Both PNS classification and trajectory membership were significant predictors of two-year functional outcomes; the DR and MI trajectories predicted greater increases in SOFAS scores (DR: b = -19.14; MI: b = -11.54) than either sPNS (b = -9.19) or PNS (b = -6.46). These findings demonstrate that combining PNS and symptom-based stratification can predict functional outcomes more accurately than either taxonomy alone. Such a combined approach could yield significant advances in developing more targeted interventions for patients at risk for poor functional outcomes.
News
Beyond the Clinic : How Digital Tools Are Transforming Bipolar Disorder Monitoring
Along with her team, Dr. Delphine Raucher-Chéné , a researcher at the Douglas Research Centre and Assistant Professor at McGill University’s Department of Psychiatry, has just published a scoping review investigating the use of digital tools in the context of bipolar disorder. The article, entitled “Digital tools for assessing bipolar disorder: A scoping review of…
Appointment of Dr. Delphine Raucher-Chéné to the CREST Network
December 5, 2025 We are pleased to announce that Dr. Delphine Raucher-Chéné has been appointed as a member of the CREST network (Collaborative Research in Early Stage Treatment). The CREST network brings together international researchers and clinicians specializing in bipolar disorder and early-stage mental health interventions. Its goal is to foster scientific collaboration, share best…
Drs. Raucher-Chéné and Wong receive NSERC funding
On July 9, 2025, the Natural Sciences and Engineering Research Council of Canada (NSERC) announced a record $660 million investment in fundamental research. Drs Delphine Raucher-Chéné and Tak Pan Wong are among the recipients of the Discovery Research Program competition. The Discovery Grants Program supports long-term research programs, fostering creativity and innovation by providing multi-year…
FRQ-Santé funds numerous Douglas researchers and students
May 2, 2025 This week, the Fonds de recherche du Québec (FRQ) announced the results of its funding applications for researcher and student salary awards. We are pleased to announce that six researchers, one DIALOGUE project and numerous students have been funded! Congratulations to all! FRQS Research Scholars Katie Lavigne – Research Scholar, Junior 1…
Dr. Delphine Raucher-Chéné obtains a 2023 Clinical Innovation Pilot Fund Award
Dr. Delphine Raucher-Chéné has obtained a McGill PSychiatry 2023 Clinical Innovation Pilot Fund Award for her project, entitled, Minds@Work for individuals with bipolar disorder. The prize amount of $25,000 is intended to support research projects relating to the implementation of clinical innovations in patient care. Congratulations to Dr. Delphine Raucher-Chéné!
Welcoming Dr. Delphine Raucher-Chéné, a recent addition to the Douglas Resarch Centre
August 3, 2023 In May, the Douglas Research Centre welcomed Dr. Delphine Raucher-Chéné to its ranks. Dr. Raucher-Chéné completed her French MD degree in psychiatry in 2010 and has worked for ten years as a full-time clinician in an academic psychiatric department in France. She furthered her research training by undertaking an M.Sc. in neuropsychology (2012), a Ph.D. in psychology (2018), and a postdoctoral fellowship (2019-2021) at McGill/Douglas…