{"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><strong>Objectives: </strong>This 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.</p><p><strong>Methods: </strong>Twenty-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.</p><p><strong>Results: </strong>There 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.</p><p><strong>Conclusions: </strong>Though 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.</p><p><strong>Clinicaltrials: </strong>gov NCT04602715.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"816-823"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","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":"Innovations in the Treatment of Mood Disorders: Exploring Microbiome, Digital and Culturally Adapted Approaches.","authors":"Muhammad Ishrat Husain, Peter Giacobbe","doi":"10.1177/07067437251374600","DOIUrl":"10.1177/07067437251374600","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"813-815"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979050","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}
Kamyar Keramatian, Alexander Levit, Heeva Chavoshi-Nejad, Clara Westwell-Roper, John-Jose Nunez, Ashley Forbes, Emma Morton, Erin E Michalak, Eduard Vieta, Lakshmi N Yatham
{"title":"Early Psychoeducational Intervention for Youth and Young Adults at Risk for Bipolar Disorder: A Feasibility Study: Intervention psychoéducative précoce pour les adolescents et les jeunes adultes à risque de trouble bipolaire : Une étude de faisabilité.","authors":"Kamyar Keramatian, Alexander Levit, Heeva Chavoshi-Nejad, Clara Westwell-Roper, John-Jose Nunez, Ashley Forbes, Emma Morton, Erin E Michalak, Eduard Vieta, Lakshmi N Yatham","doi":"10.1177/07067437251342278","DOIUrl":"10.1177/07067437251342278","url":null,"abstract":"<p><strong>Objective: </strong>Bipolar disorder (BD) often goes unrecognized and untreated for several years leading to serious consequences. We have recently developed a manualized telehealth-based group psychoeducational and resilience enhancement program for individuals at high risk for bipolar disorder (PREP-BD). The primary objective of this study was to assess the feasibility of implementing PREP-BD to enhance help-seeking intentions among high-risk individuals.</p><p><strong>Method: </strong>The intervention consisted of eight weekly, 60-minute group psychoeducation sessions conducted via Zoom. Participants (<i>N</i> = 21), aged 17 to 24 years, who met the bipolar at-risk criteria, were assigned to one of four cohorts. Primary outcomes for this feasibility trial included sign-up rate, completion rate, and acceptability as measured by the Client Satisfaction Questionnaire (CSQ-8). Preliminary efficacy was assessed using validated measures of help-seeking intentions, resilience, quality of life, and stigma, with pre- and post-intervention comparisons.</p><p><strong>Results: </strong>Our findings indicate excellent feasibility as evidenced by timely recruitment, 100% sign-up rate, and 76.19% completion rate (defined as attending at least 75% of group sessions). The intervention showed preliminary improvements in help-seeking intentions, particularly for a hypomanic scenario. Quality of life also demonstrated significant improvement, while resilience and self-stigma showed non-significant trends toward improvement.</p><p><strong>Conclusion: </strong>Our findings suggest the feasibility of implementing psychoeducation as an early identification strategy in individuals at risk for BD. Future randomized controlled trials are needed to investigate the effectiveness of PREP-BD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"834-844"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103242","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}
Brett D M Jones, Mary E Kittur, Michael S B Mak, Wei Wang, Juveria Zaheer, Shelley McMain, M Omair Husain, Anne Sonley, David Gratzer, Benoit H Mulsant, Daniel M Blumberger, M Ishrat Husain
{"title":"A Digital Dialectical Behaviour Therapy Intervention for Acute Suicidality in Psychiatric Inpatients: A Feasibility Randomised Controlled Study: Intervention numérique en thérapie comportementale dialectique en cas de suicidabilité aiguë de patients hospitalisés en psychiatrie : Étude de faisabilité contrôlée à répartition aléatoire.","authors":"Brett D M Jones, Mary E Kittur, Michael S B Mak, Wei Wang, Juveria Zaheer, Shelley McMain, M Omair Husain, Anne Sonley, David Gratzer, Benoit H Mulsant, Daniel M Blumberger, M Ishrat Husain","doi":"10.1177/07067437251337607","DOIUrl":"10.1177/07067437251337607","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and preliminary efficacy of a digital dialectical behaviour therapy (d-DBT) skills intervention in suicidal psychiatric inpatients.</p><p><strong>Methods: </strong>A parallel arm, assessor-blinded, randomized controlled trial (RCT) was conducted to compare d-DBT to standard care among psychiatric inpatients. Participants included adults admitted for suicidality (i.e., suicidal ideation or suicide attempt). The intervention group received a d-DBT intervention encompassing 5 online modules completed over 5 to 10 days, covering mindfulness, emotion regulation, and distress tolerance skills. Participants received an initial orientation but no formal therapy sessions. Daily check-ins were available for technical-related queries. Feasibility outcomes included recruitment, adherence (≥3 modules completed), retention, and acceptability (client satisfaction questionnaire-8). Efficacy outcomes included suicidality (Columbia-Suicide Severity Rating Scale [C-SSRS] total score), psychological distress (K10), emotion regulation (Difficulties in Emotion Regulation Scale-16 [DERS-16]), and clinical global impression (CGI). Linear regression models analysed group differences.</p><p><strong>Results: </strong>A total of 65 participants were recruited, of which 42 were randomized, with high d-DBT adherence rates in the intervention arm (75%). The d-DBT intervention demonstrated significant reductions in C-SSRS scores (Cohen's -1.0) compared to standard of care. No significant group differences were observed in K10, DERS-16, or CGI. High acceptability and satisfaction were reported among participants randomized to d-DBT. Challenges and limitations included maintaining follow-up postdischarge and the small sample size.</p><p><strong>Conclusion: </strong>d-DBT is feasible to implement through an RCT and may reduce suicidality and improve mental health among psychiatric inpatients. The study highlights the importance of developing accessible, evidence-based interventions for this population. Future research should focus on long-term efficacy and expanding the intervention's appeal and accessibility.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"856-864"},"PeriodicalIF":3.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103239","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}
Sarah A Iskin, Gavin J B Elias, Asma Naheed, Jessica Pinto, Uyiosa Omere, Sidney H Kennedy, Aaron Loh, Afis Ajala, Brendan Santyr, Alexandre Boutet, Andres M Lozano, Jürgen Germann
{"title":"Capturing Brain Response Patterns to Subcallosal Cingulate Deep Brain Stimulation Using Cycling fMRI: A Proof-of-Concept Study: Acquisition de schémas cérébraux de réponse à la stimulation cérébrale profonde ciblant le cortex cingulaire subgénual à l'aide de l'IRMf en cycles : étude de validation.","authors":"Sarah A Iskin, Gavin J B Elias, Asma Naheed, Jessica Pinto, Uyiosa Omere, Sidney H Kennedy, Aaron Loh, Afis Ajala, Brendan Santyr, Alexandre Boutet, Andres M Lozano, Jürgen Germann","doi":"10.1177/07067437251387573","DOIUrl":"https://doi.org/10.1177/07067437251387573","url":null,"abstract":"<p><p>BackgroundDeep brain stimulation targeting the subcallosal cingulate (SCC-DBS) is a promising therapy for treatment-resistant depression. However, the lack of a consistent, rapid behavioural response to SCC-DBS complicates the selection of optimal stimulation settings following implantation, requiring a prolonged and burdensome trial-and-error process. Immediate biomarkers of effective stimulation could overcome this problem.MethodsIn this proof-of-concept study, three patients with SCC-DBS implants were scanned at 3 T using a block-design paradigm in which stimulation alternated between \"ON\" and \"OFF\" states in 30-s cycles during a single 6.5-min acquisition. Scans were performed using participants' clinically optimized parameters. Blood-oxygen-level-dependent (BOLD) response maps were generated by contrasting DBS-ON and DBS-OFF conditions, and exploratory correlations with clinical outcome-indexed by percentage reduction in Hamilton Depression Rating Scale scores at 12 months-were also assessed.ResultsContrasting stimulation settings enabled the identification of regional BOLD signal changes associated with DBS, revealing consistent hemodynamic changes in several brain regions during active stimulation. Specifically, the precuneus, posterior cingulate cortex, middle frontal gyrus, and frontal pole exhibited decreased BOLD responses during active DBS, while the occipital cortex, middle temporal gyrus, inferior parietal lobule, and superior frontal gyrus showed increased BOLD responses. Exploratory analysis further suggested a potential correlation between precuneus BOLD signal change and clinical improvement (<i>R</i> = -0.98, p<sub>permute</sub> = 0.09).ConclusionThese findings speak to the utility of block-design fMRI with cycling DBS stimulation as a tool to identify objective, brain-based biomarkers of effective SCC-DBS, potentially expediting stimulation parameter selection and therapeutic optimization.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251387573"},"PeriodicalIF":3.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356886","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}
Molly Howland, Arushi Mahajan, Peijun Chen, Osvaldo Almeida, Kürşat Altınbaş, Hilary Blumberg, Annemiek Dols, Nicole Fiorelli, Orestes Forlenza, Beny Lafer, Andrew Olagunju, Melis Orhan, Soham Rej, Martha Sajatovic, Matthew Schurr, Christian Simhandl, Jair Soares, Ashley Sutherland, Shang-Ying Tsai, Sara Weisenbach, Joy Yala, Farren Briggs
{"title":"Relationship Between Smoking and Psychiatric and Somatic Comorbidities in Older Age Bipolar Disorder: Lien entre le tabagisme et les affections psychiatriques et somatiques concomitantes chez les personnes âgées atteintes de trouble bipolaire.","authors":"Molly Howland, Arushi Mahajan, Peijun Chen, Osvaldo Almeida, Kürşat Altınbaş, Hilary Blumberg, Annemiek Dols, Nicole Fiorelli, Orestes Forlenza, Beny Lafer, Andrew Olagunju, Melis Orhan, Soham Rej, Martha Sajatovic, Matthew Schurr, Christian Simhandl, Jair Soares, Ashley Sutherland, Shang-Ying Tsai, Sara Weisenbach, Joy Yala, Farren Briggs","doi":"10.1177/07067437251387658","DOIUrl":"https://doi.org/10.1177/07067437251387658","url":null,"abstract":"<p><p>ObjectiveSmoking has been associated with psychiatric and somatic comorbidities in bipolar disorder (BD) populations. However, studies in older age BD (OABD) populations are sparse. We hypothesized that among individuals with OABD, current and former smokers would have worse psychiatric and somatic comorbidities parameters compared to never smokers.MethodOur study used baseline cross-sectional data from 27 international studies reporting data on adults 50 years old and older (<i>N</i> = 984). Smoking status was categorized into current smokers, former smokers, and never smokers. The distribution of demographic and clinical variables was assessed. The associations between smoking status and the clinical variables were examined using multivariable models that adjusted for age, sex, and study. Multivariable models were repeated, restricting to individuals with and without cardiovascular or respiratory (cardiorespiratory) comorbidity.ResultsOur study sample was 52.8% female with a mean age of 62 years and included 347 (35.3%) never smokers, 222 (22.6%) former smokers, and 415 (42.2%) current smokers. After controlling for age, sex, and study, current depression was more prevalent in former versus never smokers and current versus never smokers. Cardiovascular comorbidity was more prevalent among former than never smokers. More current versus never smokers were taking antipsychotic medications and more current versus never smokers having lifetime substance use disorders. When stratifying by the presence of cardiorespiratory comorbidity, the only statistically significant association was higher functioning in never versus current smokers in participants without cardiorespiratory comorbidity, though non-statistically significant relationships were present between lifetime smoking and depression across strata.ConclusionsThe relationship of smoking with depression and substance use disorders is largely independent of age, sex, and, for the depression relationship, cardiorespiratory comorbidity. More smokers taking antipsychotic medications suggests that smoking is associated with a more severe BD course. Cardiovascular comorbidity may serve as a motivating factor for smoking cessation.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251387658"},"PeriodicalIF":3.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356921","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}
Rafal M Skiba, Abhijit M Chinchani, Mahesh Menon, Martin Lepage, Katie M Lavigne, Ashok Malla, Ridha Joober, Joel O Goldberg, R Walter Heinrichs, David J Castle, Amy Burns, Michael W Best, Susan L Rossell, Sebastian Walther, Todd S Woodward
{"title":"A multisite study of the overlap between symptoms and cognition in schizophrenia: Une étude multicentrique sur le chevauchement entre les symptômes et les troubles cognitifs chez les personnes atteintes de schizophrénie.","authors":"Rafal M Skiba, Abhijit M Chinchani, Mahesh Menon, Martin Lepage, Katie M Lavigne, Ashok Malla, Ridha Joober, Joel O Goldberg, R Walter Heinrichs, David J Castle, Amy Burns, Michael W Best, Susan L Rossell, Sebastian Walther, Todd S Woodward","doi":"10.1177/07067437251387565","DOIUrl":"https://doi.org/10.1177/07067437251387565","url":null,"abstract":"<p><p>ObjectiveCognitive impairment is a core feature of schizophrenia spectrum disorders. Our previous study on a first-episode psychosis cohort showed that symptoms related to impoverished/disorganized communication and motor impoverishment predicted verbal and working memory scores, respectively. This study aimed to explore those predictors in people across the range of illness chronicity.MethodsWe employed iterative Constrained Principal Component Analysis (iCPCA) to investigate the relationship between 15 cognitive measures from the MATRICS battery, including processing speed, attention, working, verbal and nonverbal memory, reasoning, and problem-solving, and 27 Positive and Negative Syndrome Scale (PANSS) items in 198 outpatients from two sites in Australia and one in Canada. The iCPCA method was used to determine symptoms that reliably predict specific combinations of cognitive measures while controlling Type I errors.ResultsWe found that a verbal memory and learning component was predicted by the PANSS item <i>Lack of Spontaneity and Flow of Conversation</i>, and a visual attention/working memory component was linked to the PANSS item <i>Motor Retardation</i>.ConclusionsThese accord with our previous findings in an early psychosis sample, that is, negative symptoms of diminished expression are key predictors of cognitive abilities in schizophrenia. Namely, communication and motor impoverishments predicted lower scores on tests of verbal memory, learning, visual attention, and working memory. These findings may inform personalized treatment approaches targeting cognitive deficits and negative symptoms in schizophrenia.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251387565"},"PeriodicalIF":3.8,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350047","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":"Home Care Services Use in Older Adults Living with Severe Mental Illness: Care Patterns Variations Before and After an Incident Dementia Diagnosis: Utilisation des services de soins à domicile chez les personnes âgées atteintes de troubles de santé mentale graves : Variation des modèles de soins avant et après un diagnostic de trouble neurocognitif.","authors":"Isabelle Dufour, Véronique Legault, Sarah Emmanuella Brou, Sébastien Brodeur, Josiane Courteau, Yohann Moanahere Chiu","doi":"10.1177/07067437251387542","DOIUrl":"10.1177/07067437251387542","url":null,"abstract":"<p><p>ObjectiveOlder adults with severe mental illness (SMI) represent a complex population with various healthcare needs, even more so when they subsequently develop dementia. While home care (HC) services are advocated for both patients with SMI and dementia, little is known regarding real-life practices, especially for individuals having both conditions. Therefore, we aimed to describe healthcare use and transitions in older adults with SMI across HC user profiles, before and after an incident dementia diagnosis.MethodWe used a retrospective cohort study drawn from Quebec health administrative data on individuals with SMI living in the community, aged 65 and older, and who received a first dementia diagnosis between 2013 and 2015. We described healthcare use 8 months prior and 2 years after the diagnosis, including hospital admissions, visits to the emergency department (ED), and long-term care (LTC) placement.ResultsA total of 3,713 individuals were included, 53% of whom were already receiving HC services before the diagnosis (Group 1), 28% received HC services only after the diagnosis (Group 2), and 19% did not receive any HC (Group 3). While Group 1 showed the highest overall healthcare use before the diagnosis, the most striking increase after the diagnosis was observed for Group 2, catching up with Group 1's levels for many indicators, and even surpassing them in some cases. HC was mainly introduced in the four months following the diagnosis in Group 2. Group 3, while showing the lowest healthcare use throughout the study period, had the second highest mortality rate after Group 1. Groups 2 and 3 were transferred to LTC and died at younger ages than Group 1, in average.ConclusionsThis study highlights potential missed opportunities for intervention, such as an earlier HC introduction which could contribute to prevent an increase in hospitalizations and ED visits, or any HC in Group 3 to mitigate mortality risk and postpone LTC placement.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251387542"},"PeriodicalIF":3.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338185","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}
Samantha Jacobson, Noah Margolese, Howard C Margolese
{"title":"GLP-1 Receptor Agonists as a Novel Solution for Antipsychotic-Induced Weight Gain in Severe and Persistent Mental Illness.","authors":"Samantha Jacobson, Noah Margolese, Howard C Margolese","doi":"10.1177/07067437251386626","DOIUrl":"10.1177/07067437251386626","url":null,"abstract":"<p><p>Patients with severe and persistent mental illness (SPMI) experience significant metabolic side effects from antipsychotic medications, including antipsychotic-induced weight gain (AIWG). This contributes to a high prevalence of obesity, insulin resistance, and type 2 diabetes in this population, ultimately reducing life expectancy. Traditional weight management strategies, such as behavioural interventions, are often less feasible in this group. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for type 2 diabetes, have shown promise in addressing AIWG by reducing weight, improving metabolic parameters, and offering potential neuroprotective and psychiatric benefits. Evidence supports the efficacy of GLP-1RAs in managing AIWG, with studies demonstrating substantial reductions in weight and body mass index without exacerbating psychiatric symptoms. However, access to these medications remains limited due to high costs and restrictive healthcare policies. Expanding access to GLP-1RAs could bridge a critical gap in care for patients with SPMI, improving both physical and mental health outcomes. Future research should focus on evaluating long-term efficacy and cost-effectiveness, particularly in the Canadian healthcare context, to inform policy changes and optimize treatment strategies.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251386626"},"PeriodicalIF":3.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304531","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}
Rebeca Barry, Geoffrey Messier, Anees Bahji, Gina Dimitropoulos, Sumantra Monty Ghosh, Julia Kirkham, Scott B Patten, Katherine Rittenbach, Faezehsadat Shahidi, David Tano, Valerie H Taylor, Dallas P Seitz
{"title":"Characteristics of Adults With Addictions and Mental Health Problems Who Have Experienced Homelessness: A Population-Based Study From Alberta, Canada: Caractéristiques des adultes aux prises avec des problèmes de dépendance et de santé mentale et ayant connu l'itinérance : une étude fondée sur la population de l'Alberta, Canada.","authors":"Rebeca Barry, Geoffrey Messier, Anees Bahji, Gina Dimitropoulos, Sumantra Monty Ghosh, Julia Kirkham, Scott B Patten, Katherine Rittenbach, Faezehsadat Shahidi, David Tano, Valerie H Taylor, Dallas P Seitz","doi":"10.1177/07067437251380732","DOIUrl":"10.1177/07067437251380732","url":null,"abstract":"<p><strong>Objective: </strong>This study seeks to understand the characteristics of individuals with addictions and other mental health (AMH) conditions who had a history of homelessness compared to those who did not experience homelessness.</p><p><strong>Method: </strong>This cross-sectional analysis used linked administrative data from Alberta, Canada on April 1, 2018. People with AMH who experienced homelessness in the year prior to index were identified using hospitalisations and emergency department (ED) visits. We used multivariable logistic regression to evaluate the association between a set of descriptive variables and homelessness, adjusted for age and sex.</p><p><strong>Results: </strong>Among the 622,614 individuals with AMH conditions, 3,390 (0.54%) had an indicator of homelessness. People experiencing homelessness (PEH) were younger (mean = 39 vs. 42 years, <i>p</i> < .001) and more frequently male (66% vs. 41%, <i>p</i> < .001) than individuals not experiencing homelessness. PEH were also more likely to be diagnosed with multiple AMH disorders (44.8% diagnosed with ≥ 4 AMH conditions vs. 3.8% of individuals without homelessness). PEH were more likely to have a history of visiting a psychiatrist (adjusted odds ratio (AOR) = 8.11, 95% CI [7.47-8.80], having an ED visit for AMH reasons (AOR = 25.44, 95% CI [22.94-28.21], and to have been hospitalised for AMH reasons (AOR = 13.53, 95%CI [12.61-14.52]).</p><p><strong>Conclusions: </strong>Within the population of individuals with diagnosed AMH conditions, PEH demonstrated increased AMH complexity, greater healthcare utilisation and a greater likelihood of almost all AMH disorders. Given the complex mental health needs of this group, they will require more intensive mental health and general medical services that must be integrated with housing and additional social support systems.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251380732"},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253837","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}