The Canadian Journal of Psychiatry最新文献

{"title":"FKBP5 Genotype Linked to Combined PTSD-Depression Symptom in Chinese Earthquake Survivors","authors":"Gen Li, Li Wang, Kunlin Zhang, Chengqi Cao, Xing Cao, Ruojiao Fang, Ping Liu, Shu Luo, Xiangyang Zhang","doi":"10.1177/0706743719870505","DOIUrl":"https://doi.org/10.1177/0706743719870505","url":null,"abstract":"Background: Post-traumatic stress disorder (PTSD) and depression are common mental disorders in individuals experiencing traumatic events. To date, few studies have studied the relationship between genetic basis and phenotypic heterogeneity of traumatized individuals. The present study examined the effects of four FKBP5 SNPs (rs1360780, rs3800373, rs9296158, and rs9470080) in four postdisaster groups (low symptom, predominantly depressive, predominantly PTSD, and combined PTSD-depression symptom groups) as identified by latent profile analysis. Methods: A total of 1,140 adults who experienced the 2008 Wenchuan earthquake participated in our study. Earthquake-related trauma, PTSD, and depressive symptoms were measured using standard psychometric instruments. The four FKBP5 SNPs were genotyped using a custom-by-design 2 × 48-Plex SNP scan™ Kit. Results: After adjusting for covariates, the main and gene–environment interaction effects of rs9470080 were all significant when the combined PTSD-depression group was compared with the low symptoms, predominantly depression and predominantly PTSD groups. rs9470080 TT genotype carriers had a higher risk of developing high co-occurring PTSD and depression symptoms than the C allele carriers. However, when trauma exposure was severe, the TT genotype carriers and C allele carriers did not differ in the risk of developing high co-occurring PTSD and depressive symptoms. The other three SNPs demonstrated no significant effects. Moreover, the rs3800373-rs9296158-rs1360780-rs9470080 haplotype A-G-C-T was found significantly associated with combined PTSD-depression symptoms. Conclusion: Our findings support the genetic basis of phenotypic heterogeneity in people exposed to trauma. Furthermore, the results reveal the possibility that the variants of FKBP5 gene may be associated with depression-PTSD comorbidity.","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115003766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicides in Young People in Ontario Following the Release of “13 Reasons Why”","authors":"M. Sinyor, Marissa Williams, U. Tran, A. Schaffer, P. Kurdyak, J. Pirkis, T. Niederkrotenthaler","doi":"10.1177/0706743719870507","DOIUrl":"https://doi.org/10.1177/0706743719870507","url":null,"abstract":"Objective: “13 Reasons Why,” a Netflix series, included a controversial depiction of suicide that has raised fears about possible contagion. Studies of youth suicide in the United States found an increase on the order of 10% following release of the show, but this has not been replicated in other countries. This study aims to begin to address that gap by examining the relationship between the show’s release and youth suicide in Canada’s most populous province. Methods: Suicides in young people (under the age of 30) in the province of Ontario following the show’s release on March 31, 2017, were the outcome of interest. Time-series analyses were performed using data from January 2013 to March 2017 to predict expected deaths from April to December 2017 with a simple seasonal model (stationary R 2 = 0.732, Ljung-Box Q = 15.1, df = 16, P = 0.52, Bayesian information criterion = 3.09) providing the best fit/used for the primary analysis. Results: Modeling predicted 224 suicides; however, 264 were observed corresponding to 40 more deaths or an 18% increase. In the primary analysis, monthly suicides exceeded the 95% confidence limit for 3 of the 9 months (May, July, and October). Conclusion: The statistical strength of the findings here is limited by small numbers; however, the results are in line with what has been observed in the United States and what would be expected if contagion were occurring. Further research in other locations is needed to increase confidence that the associations found here are causal.","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130183887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnérabilité au Trouble Bipolaire: La Piste de la Vitamine D","authors":"M. Naifar, M. Maalej Bouali, Wassim Guidara, A. Ellouze, K. Jmal, S. Omri, M. Messedi, L. Zouari, A. Elleuch, Mohamed Maalej, K. Chaabouni, Nada Charfi, M. Turki, B. T. Jihène, F. Ayadi","doi":"10.1177/0706743719870513","DOIUrl":"https://doi.org/10.1177/0706743719870513","url":null,"abstract":"Objectifs : L’étiopathogénie du trouble bipolaire (TB) demeure non encore bien élucidée. Récemment, il a été prouvé que la 25-hydroxy-vitamine D(25OHD) a un rôle anti-inflammatoire et neuroprotecteur. Nos objectifs étaient de mesurer les concentrations plasmatiques de la 25OHD chez des patients atteints de TB en décompensation aigue et de les comparer à celles de patients souffrant de schizophrénie (SCZ) ou de trouble schizo-affectif (TSA) et à celles de témoins sains Méthodes : Il s’agissait d’une étude transversale de type cas-témoins qui a inclus des patients de sexe masculin hospitalisés pour une décompensation de leur maladie et chez qui les diagnostics de TB, SCZ, ou de TSA ont été retenus selon les critères du (DSM-5). Le groupe témoin a été constitué de sujets sains non apparentés, appariés selon l’age et le sexe. Résultats : La concentration de la 25OHD était significativement plus élevée uniquement chez les patients atteints de TB par rapport aux témoins. la 25OHD était aussi corrélée positivement à l’échelle PANSS (r = 0.282, p < 0.001) et aux différents scores de l’échelle MOCA (r = 0.326, p = 0.006) ainsi qu’aux dimensions concernant la capacité d’abstraction, d’attention et la mémoire . A l’analyse multivariée, la décompensation aigue du TB était liée de manière indépendante à l’élévation de la 25OHD plasmatique (p = 0.012; OR = 1.157, [1.032 -1.297]). Conclusion : Notre étude a montré que la décompensation aigue des TB était associée à une élévation de la synthèse de la 25OHD plasmatique. Toutefois, la pertinence du dosage de la vitamine D comme biomarqueur de cette maladie mérite d’être vérifiée par d’autres études.","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115491745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fréquence et Type de Délits Commis Par des Hommes Atteints de Troubles Mentaux Graves Selon l’âge D’apparition Des Comportements Antisociaux","authors":"M. Lapalme, Karine Forget, Y. Le Corff, G. Côté","doi":"10.1177/0706743719870509","DOIUrl":"https://doi.org/10.1177/0706743719870509","url":null,"abstract":"Objectif: Il y a des différences importantes quant à la fréquence et au type de délit commis par les personnes atteintes de troubles mentaux graves (TMG), selon que leurs comportements antisociaux ont débuté en bas âge ou à l’âge adulte. Cependant, les personnes ayant manifesté des comportements antisociaux précoces ne forment pas un groupe homogène. La présente étude a pour objectif de vérifier si la précocité des comportements antisociaux peut expliquer cette hétérogénéité. Méthode: 137 hommes atteints d’un TMG sous trois statuts légaux distincts ont été recrutés. Ils ont été séparés en 3 groupes selon la précocité des comportements antisociaux. Résultats: Les participants du groupe enfance commettent plus de délits violents et sont plus nombreux à présenter un trouble de l’usage de drogues que ceux du groupe adulte. Le groupe adolescence se distingue du groupe adulte par une fréquence plus élevée de trouble de l’usage d’alcool. Aucune différence ne s’avère significative entre les groupes enfance et adolescence, mais la plupart des délits rapportés sont plus nombreux dans le groupe enfance. Conclusions: Les résultats suggèrent que l’âge d’apparition des comportements antisociaux devrait être pris en compte dans l’évaluation du risque et la prise en charge des personnes atteintes d’un TMG.","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131270506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mentally Ill Physician: Issues in Assessment, Treatment and Advocacy","authors":"M. Myers, A. Freeland","doi":"10.1177/0706743719856002","DOIUrl":"https://doi.org/10.1177/0706743719856002","url":null,"abstract":"This position paper has been substantially revised in collaboration with the Canadian Psychiatric Association’s Professional Standards and Practice Committee and approved for republication by the CPA’s Board of Directors on April 8, 2019. The original position paper, 1 now an historical document, was first approved by the Board of Directors on October 4, 1996.","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125889053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bipolar II Disorder: Frequent, Valid, and Reliable","authors":"E. Vieta","doi":"10.1177/0706743719855040","DOIUrl":"https://doi.org/10.1177/0706743719855040","url":null,"abstract":"The inclusion of bipolar II disorder as a subtype of bipolar illness in the DSM-IV is probably, from a clinical perspective, the most important change in the classification of mental disorders over the past 25 years. The recognition of this condition as a specific mental disorder has enhanced health care access, medical awareness, and research on a medical entity that had been neglected for ages in the official taxonomies. Clinicians were totally aware of this challenging group of patients who had some sort of apparently milder form of manic-depressive illness but who were burdened with frequent recurrences, lack of evidence-based treatments, and high rates of disability. Unfortunately, only in 1994 was this group of patients given a diagnostic status, with official blessing from the DSM. Some of the difficulties that academic centers, taxonomists, and researchers have had with this condition are exemplified in the article by Malhi et al. While it is true that, originally, the description of what we know today as bipolar II disorder was focused on hospitalized depressed patients with a history of hypomania, we know now that most bipolar II patients are never hospitalized but have very frequent depressive and hypomanic episodes that carry enormous morbidity and mortality. The difference between mania and hypomania is based on not only duration of symptoms but also severity and disability. Malhi et al. insist on the little relevance of the distinction between bipolar I and bipolar II disorder (which might be true for a subset of severe bipolar II patients), but they forget to mention that the actual relevance of defining bipolar II disorder lies in the distinction between this condition and major depressive disorder. Hence, while hypomania can be sometimes (but only sometimes) enjoyable and not particularly disturbing, it is possibly the best predictor of a shortly emerging depressive relapse (indicating the need of maintenance therapy with mood stabilizers) and also a strong indicator of poor response to antidepressants. Hence, for many patients with bipolar II disorder for whom depression is the main source of burden, the identification of hypomanias during the course of illness is critical to develop a treatment plan that includes, as options, mood stabilizers such as lithium or lamotrigine over antidepressants. In reality, most hypomanias carry an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic, as defined in the DSM-5. The DSM-5 field trials showed that both bipolar I disorder and bipolar II have good reliability. Interestingly, this was not the case for several other conditions that have been much less the focus of controversy, such as major depression and generalized anxiety disorder. As regards to personality disorders, the symptoms of bipolar II disorder are different from those of borderline personality (e.g., hypomania is not part of the definition of borderline personality disorder), and","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121738855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bipolar II Disorder Is NOT a Myth","authors":"A. Nierenberg","doi":"10.1177/0706743719852096","DOIUrl":"https://doi.org/10.1177/0706743719852096","url":null,"abstract":"","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122882514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: The DBT Solution for Emotional Eating. A Proven Program to Break the Cycle of Bingeing and Out-of-Control Eating","authors":"H. Bissada","doi":"10.1177/0706743719862983","DOIUrl":"https://doi.org/10.1177/0706743719862983","url":null,"abstract":"Cognitive behavior treatment (CBT) and Dialectal behavior therapy (DBT) have been the gold standard treatment for binge eating disorders. However, patients with dysregulated affect respond better to DBT, which is usually offered by psychologists and also by some psychiatrists properly trained in DBT. Most patients with binge eating disorders cannot afford the high cost of this service when offered by a psychologist. Furthermore, psychologists and psychiatrist who are well trained in DBT practice work mainly in urban centers in big cities and usually have long waiting lists. In other words, the high cost and the lack of availability of this treatment modality outside urban centers in big cities resulted in the service not being available for patients who need it the most. Drs Debra Safer, Sarah Adler, and Philip Masson remedied this issue. They developed a self-help resource book that guides the patient to overcome binge eating using a step-by-step approach to learn and practice (DBT). The book is well written and easy to understand; it is intended for patients who have never studied or practiced (DBT). The main themes of DBT, mindfulness, emotion regulation, and distress tolerance are explained in the 13 chapters of the book. A specific set of skills is addressed in each chapter, followed by exercises and homework assignments to guide the reader to think and absorb the material they learned in the chapter. The exercises and homework assignments are followed by feedback from ex-patients after they completed those exercises and homework assignments. This approach is helpful as it allows the reader to compare his or her experience in completing the assignments to those who have successfully completed the selfhelp program. The self-help program guides patients to successfully overcome binge eating via mastering and practicing DBT skills. Those skills include self-monitoring using a dietary card. Also, binge eating slips are expected and addressed by doing chain analysis first to identify and then avoid situations and events that trigger binge eating. Chain analysis replaces the usual feelings of guilt and shame the patient experiences after a binge. The patient will also learn about the emotional brain, rational brain, and how to balance the two of them to reach the desired wise mind that will guide the reader to make wise decisions that are appropriate to his or her situation. In conclusion, I highly recommend this well-written and reasonably priced book to patients who are struggling with binge eating and for whom DBT, delivered either individually or in a group, is not accessible. This book is the first self-help program that describes a step-by-step approach to DBT for binge eating disorders. The authors are internationally known for their research and innovative evidencebased treatment of adults and adolescents with binge eating and weight concerns. In this book, they have successfully translated their clinical expertise into an easy-tounderstan","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130793705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: La fin de l’Asile? Histoire de la déshospitalisation psychiatrique dans l’espace francophone au XXe siècle","authors":"R. Tempier","doi":"10.1177/0706743719860112","DOIUrl":"https://doi.org/10.1177/0706743719860112","url":null,"abstract":"","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115963691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Stahl’s Essential Psychopharmacology, Prescriber’s Guide, Antipsychotics","authors":"G. Awad","doi":"10.1177/0706743719856846","DOIUrl":"https://doi.org/10.1177/0706743719856846","url":null,"abstract":"","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133091872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}