L'innovation technologique au service de la recherche en psychiatrie : traitement de la schizophrénie résistante et gestion de la violence


Alexandre Dumais

CIUSSS de l'Est-de-l'Île-de-Montréal


Domaine : neurosciences, santé mentale et toxicomanies

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2019-2020

This research program is based on innovative interventions for treatment-refractory schizophrenia (TRS) and on the improvement of violence management. The primary project consists of Avatar Therapy (AT), which is aimed at developing a treatment using virtual reality to decrease affective and behavioral instability in patients with schizophrenia. The use of "avatar-based treatments" to simulate refractory auditory hallucinations allows patients to learn how to regulate their emotions in times when their symptoms are significant. A single-blind randomized controlled trial comparing AT to cognitive-behavioral therapy will be launched in 2019. This therapy addresses important gaps in existing pharmacological and psychosocial approaches. The research program also focuses on neurobiological specificities in patients with TRS at risk of violence. A second project using magnetic resonance imaging seeks to document the effects of Clozapine in the brain, particularly in regions shown to be dysfunctional and associated with violence. Notably, Clozapine is used for TRS patients and helps to manage the risk of violence. However, for cases with ultra-resistant schizophrenia (i.e., patients who do not respond completely to this drug),

AT may aid to potentiate their treatment. A subsequent project will therefore combine these 2 treatments to verify their complementarity in clinical and neurophysiological terms. Finally, cannabis use has been shown to be a risk factor for treatment resistance; and in one of my previous studies, chronic cannabis use was a risk factor for violence in patients with severe mental disorders. Another project comprising of a one-year longitudinal pilot study will aim to clarify the profile of cannabis use increasing the risk of violent recidivism in a psychiatric population. At the same time, I will adapt AT to treat cannabis use disorders.