Schizophrénie et violence : vers une meilleure évaluation et gestion du risque

 

Alexandre Dumais

Centre de recherche de l'Institut universitaire en santé mentale de Montréal

 

Domaine : neurosciences, santé mentale et toxicomanies

Programme chercheurs-boursiers cliniciens - Junior 1

Concours 2015-2016

Research has shown that the presence of a psychotic disorder increases the risk of violent behavior (VB). VB committed by patients with schizophrenia are sometimes extremely violent. Indeed, it is the rare homicides that focus all the media attention and are the source of stigma. The response of the health system is often elusive because current treatments are ineffective. A huge social cost in both human and financial terms are associated with it. A financial reasons being the intensity of care and services required for legal or litigious track.

This program will aim to improve the evaluation and management of VB in this population. Three sections are proposed in this research program: 1-Evaluate the neurological correlates of VB using neuroimaging; 2- Creation of a database that will be know as  "Signature of Risk"; 3- Develop specific treatments using virtual reality in order to manage risk of VB. Section 1 will aim to measure one risk factor (impulsivity) with functional magnetic resonance imaging. Studies showed that two components of impulsivity recruited distinct pathways into the brain. In the section 2, there will be a creation of a database based on the ratings of violence risk assessments clinic and patients attending the Philippe-Pinel Institute of Montreal.

The data will be used to conduct studies on bio-psychosocial risk factors for VB and the best ways to manage risk. Section 3 will aim to develop projects on managing violence risk using virtual reality. First pilot project is a treatment of chronic auditory hallucinations using avatars. Thus, the results of these researches could lead to significant changes in practice both in terms of evaluations and treatment.