Journal of the Canadian Academy of Child and Adolescent Psychiatry最新文献

{"title":"Psychiatric Medications and QTc Prolongation in the Pediatric Population.","authors":"Samantha Wong, Sonia Franciosi, Shubhayan Sanatani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Various medications used to treat psychiatric conditions are associated with prolongation of the QTc interval, which can lead to Torsades de Pointes, a deadly arrhythmia. Despite evidence of QTc prolongation, clinicians increasingly use psychiatric drugs in the pediatric population. Guidelines for prescribing many of these medications in children do not currently exist. To safely prescribe QTc prolonging drugs, especially in children with preexisting cardiovascular conditions, psychiatric providers, primary care physicians and/or pediatricians should conduct a detailed personal and family medical history, medication record, physical examination, and lab work, if clinically indicated, to rule out potential risk factors. Pharmacist input should be sought, if available. If risk factors are present and pre-treatment assessments identify cardiac risk factors, an assessment by a cardiologist may be necessary. To enhance treatment safety and mitigate QTc prolongation risks associated with psychiatric drug use in children, a standardized approach for drug prescribing that takes patient risk factors into account is proposed.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"98-112"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Depression Mediated the Association Between Moderate Income Inequality and Physical Aggression in Five Year Old Children.","authors":"Stephen Hunter, Jason Mulimba Were, Gregory Farmer, Radha Chari, Shelby S Yamamoto, Sheila McDonald, Roman Pabayo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pathways linking income inequality and health have been hypothesized, with few studies identifying the role of potential mediators pertaining to children's health.</p><p><strong>Objective: </strong>This study examined whether the association between income inequality and children's physical aggression was mediated by maternal depression, anxiety, or social support.</p><p><strong>Methods: </strong>Data were drawn from the All Our Families (AOF) longitudinal cohort based in Calgary, Canada, was used (n = 1090 mother-child dyads). Neighbourhood income inequality was measured via the Gini coefficient derived from the 2006 Canadian Census. Mothers completed the Center for Epidemiologic Scales for Depression, Spielberger State Trait Anxiety Inventory, and the Medical Outcomes Study Social Support Scales, respectively at 3 months postpartum. Maternal and child demographic characteristics were measured at 3 years postpartum. Children's physical aggression was assessed using the Behavior Assessment System for Children, Second Edition at 5 years postpartum. Multilevel path models were used.</p><p><strong>Results: </strong>Mothers in neighbourhoods with moderate income inequality had higher depression symptoms (b = 0.49, 95% CI: 0.01, 0.97) compared to mothers in the most equal neighbourhoods (low-income inequality). Maternal depression was subsequently associated with physical aggression in children (b = 0.26, 95% CI: 0.04, 0.47). Maternal social support was lower (b = -2.51, 95% CI: -4.53, -0.49) among mothers in neighbourhoods with high income inequality compared to mothers in the most equal neighbourhoods.</p><p><strong>Conclusion: </strong>The association between income inequality, maternal mental health, social support, and child physical aggression is complex. More research comprising larger, diverse samples of mother-child dyads may be required to clarify these associations.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"139-148"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Negative Online Behaviours and Problematic Social Media Use in Adolescents: Comparing Psychiatric Inpatients and Community Participants.","authors":"Anass Chraibi, Raphael Dufort Rouleau, Vincent Beaudry","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The U.S. Surgeon General's Advisory recently highlighted (2023) the urgency to better understand the impacts of social media on youth mental health, emphasizing the need to distinguish normative from problematic social media use (PSMU). This study aims to investigate specific online behaviours in adolescents, examining their association with PSMU, depressive symptoms and past abuse.</p><p><strong>Methods: </strong>247 adolescents (ages 12-17) completed online questionnaires; 124 were part of the community group (CG) and 123 were psychiatric inpatients (Hospitalized Group, HG). The Bergen Social Media Addiction Scale (BSMAS) and PHQ-9 were used to evaluate PSMU and depressive symptoms. Additionally, participants reported on cyberbullying victimization, sexting, accessing self-harm content online and past abuse. Logistic regression analyses were used to measure the strength of association of different score predictors (BSMAS, PHQ-9, abuse) on negative behaviours. Results are presented as odds ratios (OR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>The prevalence rates of negative online behaviours were similar to those in the existing literature for cyber bullying victimization (20.5%), sexting (20.4%) and self-harm content seeking (27.6%). They were all more frequent in the hospitalized group. They were also associated with PSMU: cyber bullying victimization (OR 4.54, 95% CI [1.95-10.54]), sexting (OR 5.47, 95% CI [2.37-12.81]), and self-harm content seeking (OR 4.71, 95% CI [2.07-11.09]). Moreover, negative behaviours were associated with depressive symptoms as well as past physical and sexual abuse.</p><p><strong>Conclusions: </strong>Problematic social media use (PSMU) is associated with multiple negative online behaviours. Mental health professionals should include questions about social media use and online behaviours in their clinical assessment of adolescents.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"123-130"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Loneliness Hurt? Effect of Loneliness on Inflammator Biomarkers, Appetite Hormone Regulation, and Cognitive Function Among Typically Developing Adolescents.","authors":"Shao-Lun Ko, Ju-Wei Hsu, Ya-Mei Bai, Shih-Jen Tsai, Mu-Hong Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The literature indicates that the prevalence of loneliness is increasing among adolescents. The role of loneliness in cognitive function, appetite hormone regulation, and inflamatory pathways among typically developing adolescents remains unclear.</p><p><strong>Methods: </strong>We enrolled 78 adolescents without psychiatric disorders in our study. All participants underwent measurements of appetite hormone (e.g., insulin, leptin, and ghrelin) and inflammatory marker levels (e.g., C-reactive protein, interleukin [IL]-6, and tumour necrosis factor-α) as well as cognitive function assessments (e.g., the Wisconsin Card Sorting Test and working memory tasks). Loneliness was classified as mild (≤40) or moderate (41-60) based on the participants' total scores on the University of California, Los Angeles (UCLA) Loneliness Scale.</p><p><strong>Results: </strong>Adolescents with moderate loneliness exhibited higher IL-6 levels (<i>p</i> = .014) than did those with mild loneliness. We identified no significant associations between total UCLA Loneliness Scale scores and appetite hormone levels or cognitive function (all <i>p</i> > .05). Furthermore, cognitive function did not differ between groups (all p > .05). Self-reported depressive and anxiety symptoms were higher in the moderate loneliness group than in the mild loneliness group.</p><p><strong>Discussion: </strong>Our findings indicate that loneliness is significantly associated with elevated IL-6 levels among typically developing adolescents. Loneliness may be a clinical marker for systemic inflammation and for subthreshold depression and anxiety in healthy adolescents. Further longitudinal studies are required to investigate the temporal association between loneliness and systemic low-grade inflammation.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"131-138"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generating Priorities in Eating Disorder Research: Recommendations from Canadian Young Adults and Caregivers.","authors":"Maria Nicula, Manya Singh, Jayden Lee, Courtney Habina, Nizar Bekai, Wendy Preskow, Jennifer Couturier, Gina Dimitropoulos","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Consensus-building approaches have seldom been used to develop research priorities informed by young adults and caregivers with lived eating disorder (ED) experience.</p><p><strong>Objective: </strong>To identify the most important research priorities among Canadian young adults and caregivers affected by EDs.</p><p><strong>Method: </strong>Using the Nominal Group Technique (NGT), we recruited Canadian young adults (ages 18-29) with pediatric ED treatment experience and their caregivers to participate in two separate NGT panels. The panels consisted of four stages: silent generation, round robin sharing, discussion, and ranking of the generated priorities. Priorities were weighted using a points system and later added to produce a total score for young adults and caregivers. Informed by Qualitative Description, qualitative content analysis was conducted to analyze the discussion portion of the panels.</p><p><strong>Results: </strong>The young adult (<i>n</i>=9) and caregiver (<i>n</i>=10) panels generated 19 and 24 priorities, respectively. The most highly endorsed research priorities among young adults were to improve existing treatment models, to include underrepresented groups in ED research, and to provide more ED education for healthcare providers. Caregivers also endorsed the need for research to improve ED training for healthcare providers and for more robust standard operating procedures and best practices for EDs. In the discussion, participants shared high-level recommendations, frustrations with current ED care, and positive reflections on the NGT process.</p><p><strong>Conclusions: </strong>Future research opportunities based on these generated priorities have the potential to improve alignment and relevance between ED research being conducted and the needs of young adults and caregivers affected by EDs.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"166-178"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of COVID-19 on School Absenteeism Among Canadian Children and Youth.","authors":"Maria A Rogers, Jess Whitley, David Smith, Natasha McBrearty, Lauren Gowans","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic school absenteeism is associated with adverse health and social outcomes for children and youth across development. The present paper analyzed data published by the Canadian Broadcasting Corporation in 2024 about rates of absenteeism in Canada pre-, mid-, and post-COVID-19. Data from a total of 11 regions in Canada, representing over 740,000 children in urban and rural public schools across the country, were analyzed. Non-parametric tests compared pre- and post-COVID-19 absenteeism rates, and correlations with the length of school closures were also explored. Data trends suggest that average chronic absenteeism rates increased significantly from pre- to post-COVID-19 for elementary students, but the increase for secondary students was not as marked. Elementary students living in regions with more school closures throughout the pandemic appear to have higher chronic absenteeism post-pandemic. This trend was not seen for secondary students. Although these results are exploratory in nature, the findings suggest that children, particularly those in the elementary grades, may be at risk of ongoing absenteeism as they develop. Results are discussed in the context of existing literature on absenteeism, Canada's response to the COVID-19 pandemic, and the global context.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"160-165"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Service Use Among Children with Chronic Physical Illness.","authors":"Lauren Gosse, Chloe Bedard, Scott Leatherdale, Christopher Perlman, Mark A Ferro","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Children with chronic physical illness are more likely to experience adverse mental health; however, the extent of their mental health service use is relatively unknown.</p><p><strong>Objectives: </strong>This study described the patterns of mental health service use over 24 months and identified sociodemographic and health-related factors associated with patterns of use among children with chronic physical illness.</p><p><strong>Methods: </strong>Data come from a longitudinal study of 263 children ages 2 to 16 years with chronic physical illness. Measures of mental health service use were parent-reported.</p><p><strong>Results: </strong>Approximately one quarter of parents reported that their child had some form of contact with a health professional for their mental health. Latent class analyses at baseline and 24 months determined a two-class model with one class reporting any service contact for their mental health (11.4-16.4%) while the second class reported no service use (88.6-83.7%). Child age (OR = 1.30 [1.15, 1.46]), comorbid mental health conditions (OR = 5.58 [2.19, 14.18]), elevated disability (OR = 1.09 [1.02, 1.17]), and higher parental educational attainment (OR = 3.12 [1.56, 6.26]) were associated with any service use class.</p><p><strong>Conclusion: </strong>Mental health service needs are common in children with chronic physical illness, and use of mental health services is related to sociodemographic and health-related factors. These results underscore the need to integrate physical and mental health services in this population. Future research among more diverse samples using data linkages to health records should be undertaken to mitigate the potential limitations of parent-reported service use.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"113-122"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Harm Presentations to a Pediatric Trauma Centre During the First Year of the COVID-19 Pandemic.","authors":"Madeleine J Gordon, Navitha Jayakumar, Clare L Atzema, Daphne J Korczak, Rachel H B Mitchell, Ayal Schaffer, Benjamin I Goldstein, Beverley A Orser, Doreen Yee, Lisa Fiksenbaum, Liz Hanbyul Lee Choi, Andrea Phillips, Margaret Kreller, Corey Freedman, Brandy Tanenbaum, Dorothy McDowall, Amanda K Ceniti, Mark Sinyor","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic raised concerns regarding increased youth suicidal behaviour. Trends in the volume and characteristics of hospital self-harm presentations may inform future suicide-prevention strategies.</p><p><strong>Objective: </strong>We compared the number and characteristics of pre - vs. intra-pandemic self-harm presentations to the Emergency Department (ED) of a major Canadian pediatric trauma centre.</p><p><strong>Method: </strong>Using time series analysis, we compared intra-pandemic (March 2020-February 2021) monthly self-harm presentation counts to forecasts based on the previous nine years. We compared the proportion of ED presentations for self-harm between the intra-pandemic period and the preceding three years. A detailed chart review of ED self-harm visits from March 2019 to February 2021 examined the demographic, clinical, and psychosocial features of pre- vs. intra-pandemic presentations.</p><p><strong>Results: </strong>Compared to pre-pandemic forecasts, ED self-harm presentation counts were decreased in March and May 2020 but increased in December 2020-January 2021. The self-harm proportion of ED presentations during the pandemic's first year was double that of the preceding three years (0.19% vs. 0.09%; OR=2.08, 95% CI=1.62-2.67). Compared to pre-pandemic self-harm presentations, patients presenting intra-pandemic were more likely to be seen for a psychiatry consultation in the ED or hospital ward (OR=2.38, 95% CI=1.04-5.43), to be admitted to a medical unit (OR=3.81, 95% CI=1.28-11.39), and to be living with parents (OR=2.58, 95% CI=1.09-6.09).</p><p><strong>Conclusions: </strong>The pandemic's association with the volume of self-harm visits to a pediatric ED appears to have varied throughout its duration. During the pandemic, self-harm visits had an increased representation among ED presentations and exhibited potential indicators of increased medical and psychiatric acuity.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"149-159"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Look Back And Look Ahead.","authors":"Iliana Ortega, Irfan Mian","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 3","pages":"97"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuation of a Consideration of Spanking and Spanking Bans.","authors":"John D McLennan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"34 2","pages":"2"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}