Vincent Paquin, McGill University

People have diverse experiences of psychosis. As a physician training in psychiatry, I am taught to consider multiple factors to tailor my clinical approach and the choice of treatment: the personal history and values of patients, their culture, their social and physical environments, their family background, etc. But despite these considerations, one challenge that remains is to predict how a person’s psychotic disorder will evolve over time and during treatment. I believe this question, and its implications for personalizing our interventions, are important areas in psychosis research right now.

At the 2022 SIRS Congress, I presented research that aims to explore the diversity of symptom trajectories before and during psychosis. My research is based on data from PEPP-Montréal, an early intervention service for people with a first episode of psychosis. Under the mentorship of Dr Jai Shah and colleagues, I examined patterns of symptoms, including psychotic and non-psychotic symptoms, experienced by patients of PEPP-Montréal at different stages of their psychotic disorder. We found that some of the symptoms that preceded patients’ psychotic episodes were associated with the severity of their mental health problems later during treatment. My hope is that this type of research can help us better anticipate clinical needs and personalize services according to the unique symptom profiles of people with a first episode of psychosis.

After I complete my psychiatry training at McGill University, I hope to pursue a career in psychosis research as a clinician-scientist. Attending the SIRS Congress and receiving an Early Career Award have been incredible for my career journey. I was inspired by the research, clinical, and peer support initiatives that were presented. In addition to the opportunity of sharing my work, I had the chance to meet with mentors, to network, and to get new insights into the types of research questions I want to explore next.

I think a critical direction for future research is to understand how large-scale changes, at the societal and environmental levels, are influencing mental health across the spectrum of schizophrenia and psychosis. For example, climate change will impact several determinants of mental health relevant to psychosis, and it may exacerbate health inequalities related to people’s socioeconomic status, livelihoods, and geographical location. Another development to consider is the rise of immersive technologies like virtual reality and the metaverse: because these media can foster new forms of connections (and disconnections) between individuals, they seem to hold unique opportunities and risks for people with psychosis. As immersive digital media become more disseminated and accessible, I anticipate that there will be a need for clinical counselling and policymaking around their use, and to do so, we will need to study how they affect people with and without psychosis. I hope that we can harness some of that emerging knowledge to develop new treatment options. I am thinking for example of therapies delivered via virtual reality, which have the potential to address important therapeutic needs while tapping into people’s technological preferences. At the 2022 SIRS Congress, many scientific presentations illustrated the possibilities of digital treatment options, as well as the need to be mindful of technology-related addictions and distress.

I am excited to tackle these research areas and more as I move forward in my career, and I see multidisciplinary dialogues as central to my project. Importantly for the lives of people with psychosis, knowledge should be produced and shared in collaboration with people with lived experience, their families, health professionals, and researchers from various backgrounds. SIRS provides a space that facilitates these connections, and therefore I see SIRS as playing an important role in my future research endeavors.