The central role of episodic memory impairments in psychosis
Our research laboratory have contributed significantly to this literature by combining cognitive neuroscientific techniques such as brain imaging to answer clinically relevant questions. We have observed that people with schizophrenia exhibit a selective memory deficit for relational memory (1) and this deficit relates to abnormalities in the hippocampo-prefrontal system (2). This work has examined the whole continuum of psychosis from clinical high risk (3), early psychosis (4) and enduring schizophrenia (5). Importantly, we have shown that such memory impairments selectively and negatively influence clinical (6) and functional (7) trajectories.
Longitudinal outcomes studies in first episode psychosis
Since 2004, we have developed a unique expertise in longitudinal studies of early psychosis by combining clinical, neurocognitive and neuroimaging data. This has made it possible the exploration of prognostication of outcome using neurocognition and neuroimaging data combined with symptom data. In a series of publications, we have examined remission of both positive and negative symptoms following a first episode of psychosis and identified neurocognitive and brain measures of early remission from psychosis (1). We have recently refined this work with a stronger focus on persistent negative symptoms (2). We have also systematically examined the longitudinal evolution of insight and how it relates to structural changes in the brain (3). We are still conducting longitudinal studies using a novel and high resolution imaging protocol.
Psychological interventions in schizophrenia and related disorders
Another significant area of interest, development and contributions concerns the development of psychological interventions for people with a psychotic disorder. Since 2010, we have conducted multiple research projects involving cognitive remediation therapy (1) and cognitive behavioral therapy (2). We have received fundings (including CIHR and a FRQS Research Chair) to conduct randomized controlled trials and test the efficacy of our novel interventions. The development of such interventions has been greatly facilitated by the creation of the Centre for Personalized Psychological Intervention for Psychosis (CI3P) at the Douglas Institute.
It is thanks to the vision and audacity of Amine Saadi, Assistant Director of Specialized Services, Chantal Fournier, Coordinator of Adult Mental Health Continuum, and Dr. Martin Lepage, clinical psychologist and researcher, that the CI3P was born in 2016. This innovative project is also made possible by the collaboration of the Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal, Mental Health and Addiction Programs Directorate.
The CI3P integrates all psychological resources for psychosis (psychologists, neuropsychologists & interns in psychology) and embeds related researchers and students all under one roof.
This clinic gives psychological interventions to outpatient and inpatient clinics associated with the Psychosis Program. We provide services to more than 150 patients per year and offers individual and group interventions. The vast majority of service users (about 90%) also engages in research activities including novel interventions and other types of clinical research. As such, this clinic is central to our psychological intervention studies.