Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie最新文献

{"title":"Regional Variation in Supply and Use of Psychiatric Services in 3 Canadian Provinces: Variation régionale de l'offre de services psychiatriques et de leur utilisation dans trois provinces canadiennes.","authors":"David Rudoler, Ridhwana Kaoser, M Ruth Lavergne, Sandra Peterson, James M Bolton, Matt Dahl, François Gallant, Kimberley P Good, Myriam Juda, Alan Katz, Jason Morrison, Benoit H Mulsant, Alison L Park, Philip G Tibbo, Juveria Zaheer, Paul Kurdyak","doi":"10.1177/07067437251322404","DOIUrl":"https://doi.org/10.1177/07067437251322404","url":null,"abstract":"<p><p>ObjectiveTo examine the patterns in the supply and use of psychiatric services in 3 Canadian provinces: British Columbia, Manitoba, and Ontario.MethodsWe conducted a repeated cross-sectional analysis spanning fiscal years 2012/13 to 2021/22, using patient- and psychiatrist-level data aggregated into administrative health regions. Descriptive statistics and linear regression were used to assess patterns and relationships between the per capita number of psychiatrists (\"supply\") and measures of use of psychiatric services (\"utilization\"), including any psychiatrist contact, psychiatric consultation (1-2 visits with the same psychiatrist), and ongoing psychiatric care (3 or more visits with the same psychiatrist).ResultsThe number of psychiatrists per capita remained stable within the 3 provinces during the study period. In 2021/22, Vancouver had the highest number in British Columbia (45 psychiatrists per 100,000 individuals), compared to 14 per 100,000 in lower-supply regions. Toronto had the highest number in Ontario (38 per 100,000), compared to 9 in lower supply regions. Winnipeg had the highest number in Manitoba (25 per 100,000), compared to 7 in the lower supply regions. In 2021/22, the per capita number of psychiatrists was moderately correlated with any psychiatrist contact (<i>R</i>² = 0.290) and ongoing psychiatric care (<i>R</i>² = 0.411), but weakly correlated with psychiatric consultation (<i>R</i>² = 0.005). The relationship between supply and utilization diminishes with higher levels of regional supply.ConclusionsPsychiatrists were unevenly distributed within and across provinces. While more psychiatrists are needed, the moderate and diminishing relationships between their numbers and utilization suggest that increasing this number alone is unlikely to fully address unmet needs for mental healthcare. Strategies to improve access will need to directly target uneven distributions. Further research is needed to understand the factors influencing psychiatrists' practice choices and ways to better support them in increasing their access to care.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251322404"},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mental Health of Refugee Claimants and Undocumented Migrants.","authors":"Sarah Hanafi, Rachel Kronick, Cécile Rousseau","doi":"10.1177/07067437251316454","DOIUrl":"https://doi.org/10.1177/07067437251316454","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251316454"},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey Exploring People's Experiences With Lithium Bought as a Supplement: Une enquête sur l'expérience des personnes avec le lithium en supplément.","authors":"Rebecca Strawbridge, Samuel Myrtle, Pietro Carmellini, Elliot Hampsey, David A Cousins, Allan H Young","doi":"10.1177/07067437251328282","DOIUrl":"https://doi.org/10.1177/07067437251328282","url":null,"abstract":"&lt;p&gt;&lt;p&gt;ObjectiveLithium, despite its evidence base and range of indications, is often underutilized due to safety concerns associated with high-dose prescriptions and consequent necessity for regular blood monitoring. Emerging evidence suggests its potential benefits at lower doses, especially for its pro-cognitive effects and positive safety profile. While accessible as a supplement, empirical human evidence on neuropsychiatric effects is lacking. This study aimed to provide preliminary evidence regarding the utilization and perceived effects of low-dose lithium supplements (LiS) in the community.MethodsCross-sectional, opportunistic survey of 211 participants aged ≥18 years who disclosed taking over-the-counter lithium supplements. The survey assessed sample demographics, supplement details, overall perspectives, and personal experiences related to the use of LiS.ResultsThe most common form of LiS taken was aspartate at 10 mg once per day, although lithium orotate and ionic lithium were also frequently used. The most common beliefs regarding the benefits of using lithium as a supplement concern efficacy for anxiety, but the most common improvements experienced was in the domain of cognition, closely followed by anxiety and mood. Mood was most commonly reported as the greatest improvement. Side effects and withdrawal phenomena were more prevalent than anticipated.ConclusionThis study revealed a diverse range of lithium supplements taken, in terms of dosage, formulation, frequency, and duration of intake. Anecdotal evidence highlighted prevalent perceived benefits and adverse effects. The study is, however, limited notably by its cross-sectional opportunistic design; more robust evidence, especially from controlled trials, is needed to fully establish the specific benefits and drawbacks associated with different forms and doses of accessible lithium supplements.Plain Language Summary TitleA survey exploring people's experiences with lithium bought as a supplement.&lt;b&gt;Plain Language Summary&lt;/b&gt;Lithium is the oldest effective medication used in psychiatry and holds an important place today. However, there are challenges with lithium in high doses and it may still be effective in low doses. Lower doses of lithium can be bought as a supplement over the counter, but this version of lithium has not been studied in research. We did a survey aiming to tell us some information about the experiences of people who have taken this supplementary lithium (\"LiS\"). From 211 adults who completed our study, results suggested that LiS is taken in many different forms, at different doses, frequencies and for different durations. People commonly believed and/or found that LiS was beneficial for anxiety, mood and cognition. Side effects and symptoms after stopping LiS were, however, more common than expected. Because this was just an initial survey, more in depth and rigorous research studies are needed to fully understand the exact benefits and drawbacks associated wit","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328282"},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Antidepressant Effects of Psilocybin-Assisted Psychotherapy in Individuals That Were Unmedicated at Initial Screening Versus Individuals Discontinuing Medications for Study Participation: Comparaison des effets antidépresseurs de la psychothérapie assistée par la psilocybine (PAP) chez les personnes non médicamentées à la sélection initiale et les personnes ayant arrêté les médicaments pour participer à l'étude.","authors":"Noah Chisamore, Erica S Kaczmarek, Zoe Doyle, Danica E Johnson, Geneva Weiglein, Shakila Meshkat, Ryan M Brudner, Marc G Blainey, Jeremy Riva-Cambrin, Roger S McIntyre, Joshua D Rosenblat","doi":"10.1177/07067437251328316","DOIUrl":"10.1177/07067437251328316","url":null,"abstract":"<p><p>ObjectiveTo compare changes in depression, anxiety, and suicidality symptoms after a single 25 mg oral dose of psilocybin between treatment-resistant depression participants not on antidepressants at screening to participants that discontinued antidepressant medications leading up to receiving psilocybin-assisted psychotherapy (PAP).MethodsParticipants (n = 27) received at least one 25 mg dose of psilocybin accompanied by psychotherapy as part of an exploratory analysis from an open-label, randomized, waitlist-controlled clinical trial. The primary outcome of changes in depression symptoms was measured by the Montgomery-Åsberg Depression Rating Scale (MADRS). Secondary outcomes included changes in anxiety symptom severity (Generalized Anxiety Disorder 7-Item [GAD-7]), suicidal ideation (MADRS Item-10), self-reported depression symptoms (Quick Inventory for Depression Symptomology [QIDS-SR]), and intensity of psychedelic experience (Mystical Experience Questionnaire 30-item [MEQ30]). Patients were separated into two groups for analysis; those who were unmedicated at initial screening versus participants that had to taper off antidepressant medications to be eligible for the trial. A mixed analysis of variance was used to evaluate clinical outcomes over time from baseline to 2 months post-dose.ResultsNo significant differences were found between medication discontinued (n = 18) and unmedicated at screening (UAS) (n = 9) groups in clinician rated depression (p = 0.759), self-reported depression (p = 0.215), anxiety (p = 0.178), and suicidality (p = 0.882) symptoms over time, with both groups having clinically significant benefits on all outcomes assessed. Both groups also had a similar intensity of psychedelic experience (p = 0.191).ConclusionComparable improvements were observed in depression and anxiety and symptoms between antidepressant discontinued and UAS patients. These findings contrast with and contribute to the growing literature on the effects of medication tapering leading up to PAP. Further clinical research is needed to directly compare efficacy across medication statuses, in addition to evaluating psychedelic effects in individuals continuing antidepressants during PAP.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328316"},"PeriodicalIF":3.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Tailored Approach to Care and Service Delivery for Women with Perinatal Mental Health Conditions-Commentary on the Canadian Network for Mood and Anxiety Treatments (CANMAT) 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety and Related Disorders.","authors":"Prabha S Chandra, Preethi V Reddy","doi":"10.1177/07067437251328248","DOIUrl":"10.1177/07067437251328248","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328248"},"PeriodicalIF":3.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Delayed Sleep-Wake Phase Disorder and Depression Among Young Individuals: A Systematic Review and Meta-Analysis: Association entre le syndrome de retard de phase et la dépression parmi les jeunes : revue systématique et méta-analyse.","authors":"Manish H Dama, Josh Martin, Vanessa K Tassone, Qiaowei Lin, Wendy Lou, Venkat Bhat","doi":"10.1177/07067437251328308","DOIUrl":"10.1177/07067437251328308","url":null,"abstract":"<p><p>ObjectivesDelayed sleep-wake phase disorder (DSWPD) most commonly affects young individuals (adolescents and young adults), but it is often undetected in clinical practice. Despite several reports suggesting a link between DSWPD and depression, no systematic review has investigated this association. The aim of this systematic review was to determine whether DSWPD is associated with depression among young individuals.MethodsMEDLINE, EMBASE, PsycINFO, and CINAHL Plus were searched up to 29 July 2024. Primary studies investigating DSWPD and depression among young individuals were eligible. Methodological quality and risk of bias was assessed with the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Common-effect models were conducted to examine the relationship between DSWPD status (categorical variable: yes or no) and depression severity (continuous variable). PROSPERO ID: CRD42023458889.ResultsSixteen studies were included with 766 participants being evaluated against the diagnostic criteria for DSWPD from the International Classification of Sleep Disorders. Thirteen out of 15 studies demonstrated that young individuals with DSWPD had a significantly greater severity of depressive symptoms than young individuals without DSWPD. NIH quality assessment scores ranged between 5 and 9 (out of a total of 11). DSWPD status had a significantly large effect on depression severity in the common-effect model (<i>N</i>: 16 estimates, 693 participants, Cohen's <i>d </i>= 0.92, 95% confidence interval (95% CI) [0.76-1.08]). The subgroup analysis also demonstrated significant findings with the common-effect model that only utilized data from studies that controlled for psychiatric disorders (<i>N</i>: 12 estimates, 535 participants, Cohen's <i>d </i>= 0.88, 95% CI [0.70-1.06]).ConclusionsDSWPD is associated with a greater severity of depressive symptoms among young individuals. Although more research is required to understand this association, it may be useful to consider the presence of DSWPD when managing young individuals who present with persistent sleep disturbances (e.g., sleep-onset insomnia) and depressive symptoms.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328308"},"PeriodicalIF":3.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Insight Dimensions and Symptom Dynamics in Schizophrenia: A Data-Driven Network Approach: Cartographie des dimensions d'insight et de la dynamique symptomatique dans la schizophrénie: une approche par réseau fondée sur les données.","authors":"Jesse Rae, Katie M Lavigne, Geneviève Sauvé, Martin Lepage, Delphine Raucher-Chéné","doi":"10.1177/07067437251329074","DOIUrl":"10.1177/07067437251329074","url":null,"abstract":"<p><p>ObjectivesPatients with <i>schizophrenia spectrum disorders</i> (SSD) present with cognitive, behavioral, and emotional difficulties. Affected individuals often exhibit poor insight into aspects of their illness, such as awareness of the illness itself or the need for treatment, which can hinder treatment adherence and complicate clinical outcomes. This study aimed to investigate the relationships between clinical symptoms and dimensions of insight in SSD using a network approach, which captures direct and indirect relationships among variables. We hypothesized that illness awareness would correlate negatively with positive symptoms and positively with depressive symptoms, and that positive symptoms would have the strongest influence on the network.MethodsData were collected from 142 individuals diagnosed with SSD. Insight was measured using the Birchwood Insight Scale (IS) across three dimensions: illness awareness, symptom re-labelling, and awareness of the need for treatment. Symptoms were evaluated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, the Calgary Depression Scale and the Hamilton Anxiety Scale. Network analysis was employed to explore interconnections (edges) between variables (nodes) and identify influential variables through centrality measures (strength, betweenness, closeness).ResultsA significant positive connection was found between illness awareness and depressive symptoms. Anxiety and depressive symptoms were identified as the most central and influential variables within the network. Treatment awareness showed greater centrality than illness awareness, indicating this dimension's potential importance in influencing symptom dynamics in a clinical profile.ConclusionsAnalyzing a more extensive network that includes treatment adherence and cognitive domains affected in SSD could enhance and validate the understanding of the cascading effects of symptoms and insight dimensions, allowing for more tailored treatments.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251329074"},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Safety and Efficacy of Microbial Ecosystem Therapeutic-2 in People With Major Depression - A Phase 2, Double-Blind, Placebo-Controlled Study: Clinical Results: Innocuité et efficacité du traitement de l'écosystème microbien (met-2) dans la dépression majeure - une étude de phase 2 à double insu contrölée par placebo : résultats cliniques.","authors":"Arthi Chinna Meyyappan, Cassandra Sgarbossa, Hayley Bromley, Evan Forth, Daniel J Müller, Gusatvo Vazquez, Casimiro Cabrera, Roumen Milev","doi":"10.1177/07067437251328270","DOIUrl":"10.1177/07067437251328270","url":null,"abstract":"<p><p>ObjectivesThis study examines the safety and efficacy of a fecal transplant alternative, Microbial Ecosystem Therapeutic-2 (MET-2), in improving symptoms of depression. The primary objective of this study is to assess changes in depressive symptoms before, during, and after administration of MET-2 in comparison to placebo. Mood-related symptoms such as anxiety and anhedonia, gastrointestinal symptoms, and safety of the therapeutic were also assessed using both self-report and clinician-rated measures.MethodsTwenty-nine participants (<i>n </i>= 29) experiencing a major depressive episode were recruited from the Kingston and Toronto areas. Participants orally consumed MET-2, an encapsulated microbial therapeutic containing 40 different strains of bacteria, or placebo alternative, once daily for 6 weeks with a 2-week follow-up. Participants underwent a series of clinical assessments used to measure mood, anxiety, and gastrointestinal symptoms.ResultsThere was a significant improvement in depressive symptomology over time as determined by Montgomery-Åsberg Depression Rating Scale scores (<i>p </i>< 0.0001); however there was no significant difference between placebo and MET-2 groups (<i>p </i>= 0.338). No serious adverse events were reported. The findings of this study are the first to provide evidence for the role of oral microbial therapeutics, such as MET-2, as treatment for symptoms of depression.ConclusionsThough there are positive trends suggesting a greater improvement in depressive symptomology among the MET-2 group compared to the placebo group, a larger sample size is needed for more conclusive results. Clinicaltrials.gov NCT04602715.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328270"},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"French Validation of the Brief Negative Symptom Scale (BNSS).","authors":"Lucie Métivier, Maxime Tréhout, Elise Leroux, Maud Rothärmel, Sonia Dollfus","doi":"10.1177/07067437251328350","DOIUrl":"10.1177/07067437251328350","url":null,"abstract":"<p><p>ObjectivesThis study aims to validate the French version of the Brief Negative Symptom Scale (BNSS) by assessing its psychometric properties in a population of patients with schizophrenia or schizoaffective disorder.Methods73 patients with schizophrenia or schizoaffective disorder were included. Participants were evaluated using the BNSS, the Positive and Negative Syndrome Scale (PANSS), and the Self-Evaluation of Negative Symptoms (SNS). The internal consistency of the BNSS was measured using Cronbach's alpha, structural validity was assessed through exploratory factor analysis, and construct validity was evaluated with Spearman correlations between BNSS scores, the negative subscale of the PANSS, the total SNS score, the positive subscale of the PANSS, and PANSS items evaluating insight and depressive mood.ResultsThe internal consistency of the BNSS was excellent (Cronbach's alpha = 0.93). Exploratory factor analysis revealed two factors corresponding to the motivational and expressive dimensions of negative symptoms. Significant positive correlations were found between total BNSS scores and the negative subscale of the PANSS (Rho = 0.77; <i>p</i> < 0.001), as well as with SNS scores (Rho = 0.55; <i>p</i> < 0.001). No correlation was observed between total BNSS scores and the positive subscales of the PANSS (Rho = 0.09; <i>p</i> = 0.41). However, significant positive correlations were noted with the PANSS item assessing depression (Rho = 0.28; <i>p</i> = 0.015) and insight (Rho = 0.43; <i>p</i> < 0.001).ConclusionThe French version of the BNSS has demonstrated strong psychometric properties and is suitable for clinical and research use.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328350"},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Functional Connectivity of Frontolimbic Circuit During Symptom Provocation in Distinct Symptom Profiles of Obsessive-Compulsive Disorder: Connectivité fonctionnelle différentielle du circuit frontolimbique durant la provocation de symptômes dans des profils symptomatiques distincts du trouble obsessionnel-compulsif.","authors":"Navya Spurthi Thatikonda, Janardhanan C Narayanaswamy, Ganesan Venkatasubramanian, Y C Janardhan Reddy, Shyam Sundar Arumugham","doi":"10.1177/07067437251328368","DOIUrl":"10.1177/07067437251328368","url":null,"abstract":"<p><p>BackgroundEmotional processing deficits and frontolimbic dysfunction have been observed in patients with obsessive-compulsive disorder (OCD), with inconsistent evidence possibly due to symptom heterogeneity. We compared the functional activation and connectivity patterns of the frontolimbic structures during symptom provocation between patients with distinct symptom profiles of OCD.MethodsThirty-seven symptomatic OCD subjects were recruited and categorized based on predominant symptom profiles to contamination/washing symptom group (OCD-C, n = 19) and taboo thoughts group (OCD-T, n = 18), along with 17 healthy controls (HCs). All subjects were evaluated with comprehensive clinical assessments and functional magnetic resonance imaging while appraising personalized disorder-specific stimuli with contrasting neutral stimuli as part of an individualized symptom provocation task. Region of interest analyses and task-dependent seed-to-voxel connectivity of the frontolimbic circuit were compared between the groups, with correction employed for multiple comparisons.ResultsOCD-C subjects had decreased task-dependent mean activation of the left amygdala (adjusted mean difference = 13.48, p= 0.03) and right hippocampus (adjusted mean difference = 13.48, p = 0.04) compared to HC. Task-modulated functional connectivity analyses revealed that OCD-C had decreased connectivity of the right hippocampus with bilateral supplementary motor cortex and anterior cingulate gyrus (T = -5.11, p = 0.04); right insula with left cerebellum (T = -5.47, p = 0.02); and left insula with inferior temporal gyrus (T = -6.27, p = 0.03) than HC. OCD-T subjects had greater connectivity of right insula with left cerebellum (T = 6.64, p < 0.001) than OCD-C and increased connectivity of medial frontal cortex with right lateral occipital cortex (T = 5.08, p < 0.001) than HC.ConclusionsContamination-related symptoms were associated with decreased activation and connectivity of amygdala and hippocampus during symptom provocation, while the taboo thoughts were associated with increased connectivity of the insular cortex and medial frontal cortex. These findings suggest that distinct neurobiological markers may underlie the clinical heterogeneity of OCD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328368"},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}