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

{"title":"Extending the Impact of Mood Disorder Care Through Treatment Optimization and Accessibility.","authors":"Peter Giacobbe, Muhammad Ishrat Husain","doi":"10.1177/07067437251374563","DOIUrl":"10.1177/07067437251374563","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":"70 10","pages":"729-731"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082397","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":"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><strong>Objective: </strong>To 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).</p><p><strong>Methods: </strong>Participants (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.</p><p><strong>Results: </strong>No 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).</p><p><strong>Conclusion: </strong>Comparable 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":"759-767"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","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":"Integrating Indigenous Ways of Knowing Into Learning Health Systems: Moving From Learning Health Systems to Learning Communities.","authors":"Carolyn M Melro, Kathleen MacDonald, Tovah Cowan, Brenda Restoule, Elder Tecumseh Ed Connors, Gina Marandola, Christopher J Mushquash, Srividya N Iyer","doi":"10.1177/07067437251380734","DOIUrl":"https://doi.org/10.1177/07067437251380734","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251380734"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208484","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":"Magnetic Seizure Therapy in Refractory Psychiatric Disorders: A Systematic Review and Meta-Analysis: La thérapie par convulsions magnétiques pour la prise en charge des troubles psychiatriques réfractaires : revue systématique et méta-analyse.","authors":"Jake Prillo, Lorina Zapf, Caroline W Espinola, Zafiris J Daskalakis, Daniel M Blumberger","doi":"10.1177/07067437241301005","DOIUrl":"10.1177/07067437241301005","url":null,"abstract":"<p><strong>Objective: </strong>To qualitatively and quantitatively synthesize the literature on the efficacy and safety of magnetic seizure therapy (MST) in psychiatric disorders.</p><p><strong>Methods: </strong>A literature search was conducted of the OVID Medline, OVID EMBASE, PsychINFO, CINAHL, Web of Science and Cochrane databases from inception to 14 January 2024, using subject headings and key words for \"magnetic seizure therapy.\" Randomized controlled trials (RCTs), post-hoc analyses of RCTs, open-label trials, or case series investigating MST in adults with a verified psychiatric diagnosis and reporting on two possible primary outcomes (1) psychiatric symptom reduction (as measured by validated rating scale) or (2) neurocognitive outcomes (as measured by standardized testing), were included. Abstracts, individual case reports, reviews and editorials were excluded. Extracted data included: (1) basic study details; (2) study design; (3) sample size; (4) baseline demographics; (5) outcome data (including secondary outcomes of suicidal ideation and adverse events); and (6) stimulation parameters. Cochrane's risk of bias tool was applied. A quantitative analysis was conducted for the depression studies, using Hedge's g effect sizes.</p><p><strong>Results: </strong>A total of 24 studies (n = 377) were eligible for inclusion. Seventeen studies in depression (including three RCTs), four studies in schizophrenia (including one RCT), one study in bipolar disorder, one study in obsessive-compulsive disorder and one study in borderline personality disorder were summarized. We found no significant difference in depressive symptom reduction between MST and electroconvulsive therapy (ECT) in randomized, controlled trials (g = 0.207 towards ECT, 95% confidence interval (CI) -0.132 to 0.545, <i>P</i> = 0.232). We found a significant reduction in depressive symptoms overall with MST in the pooled RCT and open-label analysis (g = 1.749, CI 1.219 to 2.279, <i>P</i> < 0.005). It is suggested that MST has modest cognitive side effects.</p><p><strong>Conclusions: </strong>Large-scale RCTs are necessary to confirm early signals of MST as an effective intervention in psychiatric disorders with a cognitive profile that is potentially more favourable than ECT.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"732-749"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803502","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":"Personalising Antidepressant Treatment for Unipolar Depression Combining Individual Choices, Risks and big Data: The PETRUSHKA Tool: Personnalisation du traitement antidépresseur de la dépression unipolaire associant choix individuels, risques et mégadonnées: l'outil PETRUSHKA.","authors":"Edoardo G Ostinelli, Matt Jaquiery, Qiang Liu, Rania Elgarf, Nyla Haque, Jennifer Potts, Zhenpeng Li, Orestis Efthimiou, Sarah Markham, Roger Ede, Laurence Wainwright, Karen Barros Parron Fernandes, Bianca Barros Parron Fernandes, Paulo Victor Carpaneze Dalaqua, Anneka Tomlinson, Katharine A Smith, Caroline Zangani, Franco De Crescenzo, Marcos Liboni, Benoit H Mulsant, Andrea Cipriani","doi":"10.1177/07067437251322399","DOIUrl":"10.1177/07067437251322399","url":null,"abstract":"<p><strong>Objective: </strong>We summarize the key steps to develop and assess an innovative online, evidence-based tool that supports shared decision-making in routine care to personalize antidepressant treatment in adults with depression. This PETRUSHKA tool is part of the PETRUSHKA trial (Personalize antidEpressant Treatment foR Unipolar depreSsion combining individual cHoices, risKs, and big datA).</p><p><strong>Methods: </strong>The PETRUSHKA tool: (a) is based on prediction models, which use a combination of advanced analytics, i.e., traditional statistics, and machine learning methods; (b) utilizes electronic health records from primary care patients with depressive disorder in England and data from randomized controlled trials on antidepressants in depression, both at aggregate and individual patient level; (c) incorporates preferences from patients and clinicians (especially about adverse events); (d) generates a ranked list of personalized treatment recommendations to inform the discussion between clinicians and patients, and facilitates the final treatment choice. The PETRUSHKA tool is implemented as a web-based application, accessible from any computer, smartphone or tablet.</p><p><strong>Results: </strong>We employed a bespoke algorithm to identify the best antidepressant for each individual patient, using patients' clinical and demographic characteristics and harnessing the power of innovations in digital technology, large datasets and machine learning. We established a dedicated group of patient representatives that were involved in the co-production of the tool, to maximize its impact in real-world clinical practice across the world. To test the tool, we designed an international multi-site, randomized trial (target sample: 504 participants), comparing the PETRUSHKA tool with usual care to personalize pharmacological treatment in patients with depressive disorder across Brazil, Canada and the UK.</p><p><strong>Conclusions: </strong>Using evidence-based patient decision aids has been recommended to support shared decision-making when quality is assured. Future studies in precision mental health should develop multimodal web tools, incorporating patients' preferences and their individual demographic, cultural, clinical, and genetic characteristics.Plain Language Summary TitleTailoring antidepressant treatment to individual patients with depression: the PETRUSHKA tool.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"768-781"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626942","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":"Impact of Comorbid Posttraumatic Stress-Related Symptoms on Repetitive Transcranial Magnetic Stimulation for Depression in Civilians: Incidence des symptômes du trouble de stress post-traumatique (TSPT) comorbide sur la stimulation magnétique transcrânienne répétitive pour traiter la dépression.","authors":"Enoch Ng, Sean M Nestor, Jennifer S Rabin, Clement Hamani, Nir Lipsman, Peter Giacobbe","doi":"10.1177/07067437251342277","DOIUrl":"10.1177/07067437251342277","url":null,"abstract":"<p><strong>Objectives: </strong>The impact of comorbid posttraumatic stress disorder (PTSD) symptoms on the anti-depressive outcomes of repetitive transcranial magnetic stimulation (rTMS) for civilians with major depressive disorder (MDD) is poorly studied. We aimed to understand whether proximal PTSD symptoms would interact with distal traumas in impacting depression outcomes from rTMS treatment.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 133 patients with MDD receiving open-label high-frequency rTMS to the left dorsolateral prefrontal cortex for 4 weeks. Probable PTSD was defined as scoring ≥ 4 on the Primary Care PTSD Screen for DSM-5. Distal traumas were quantified using the Adverse Childhood Experiences (ACE-10) questionnaire. Primary outcomes were improvement in Hamilton Rating Scale for Depression 17 item scale (HAMD-17) scores from baseline to 4 weeks as well as remission (HAMD-17 ≤ 7) and response (greater than 50% improvement from baseline).</p><p><strong>Results: </strong>29/133 had probable PTSD. Patients with probable PTSD had more ACEs, as well as higher depression, anxiety and medical comorbidity scores. Neither probable PTSD status nor its interaction with ACEs significantly impacted depression outcomes. However, having more ACEs was associated with greater odds of remission and response.</p><p><strong>Conclusions: </strong>Our findings suggest neither co-morbid PTSD symptoms nor distal childhood adversities should preclude patients with MDD from receiving rTMS for depression.Plain Language Summary TitleRepetitive transcranial magnetic stimulation for civilian patients with depression and posttraumatic stress symptoms.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"796-805"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182747","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":"Procognitive Effects of Adjunctive D-Cycloserine to Intermittent Theta-Burst Stimulation in Major Depressive Disorder: Effets procognitifs de la D-cyclosérine en traitement complémentaire par la stimulation thêta-burst intermittente dans le trouble dépressif caractérisé.","authors":"Marilena M DeMayo, Jaeden Cole, Myren N Sohn, Signe L Bray, Ashley D Harris, Scott B Patten, Alexander McGirr","doi":"10.1177/07067437241293984","DOIUrl":"10.1177/07067437241293984","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder (MDD) is associated with cognitive impairments that persist despite successful treatment. Transcranial magnetic stimulation is a noninvasive treatment for MDD that is associated with small procognitive effects on working memory and executive function. We hypothesized that pairing stimulation with N-methyl-D-aspartate (NMDA) receptor agonism would enhance the effects of stimulation and its procognitive effects.</p><p><strong>Method: </strong>The effect of NMDA receptor agonism (D-cycloserine, 100 mg) on cognitive performance was tested in two randomized double-blind placebo-controlled trials: (1) acute effects of in the absence of stimulation (<i>n </i>= 20 healthy participants) and (2) a treatment study of individuals with MDD (<i>n </i>= 50) randomized to daily intermittent theta-burst stimulation (iTBS) with placebo or D-cycloserine for 2 weeks. Cognitive function was measured using the THINC-it battery, comprised of the Perceived Deficits Questionnaire, the Choice Reaction Time, the Trail Making Test, the Digit Symbol Substitution Test, and the 1-Back tests.</p><p><strong>Results: </strong>D-cycloserine had no acute effect on cognition compared to placebo. iTBS + D-cycloserine was associated with significant improvements in subjective cognitive function and correct responses on the 1-Back when compared to iTBS + placebo. Improvements in subjective cognition paralleled depressive symptoms improvement, however 1-Back improvements were not attributable to improvement in depression.</p><p><strong>Conclusions: </strong>An intersectional strategy pairing iTBS with NMDA receptor agonism may restore cognitive function in MDD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"750-758"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523676","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 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":"10.1177/07067437251328282","url":null,"abstract":"<p><strong>Objective: </strong>Lithium, 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.</p><p><strong>Methods: </strong>Cross-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.</p><p><strong>Results: </strong>The 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.</p><p><strong>Conclusion: </strong>This 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.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"782-795"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954165/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Principles Underlying Mental Health Legislation.","authors":"Richard L O'Reilly, Grainne Neilson, Mathieu Dufour, Gary Chaimowitz","doi":"10.1177/10556656251339898","DOIUrl":"10.1177/10556656251339898","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"10556656251339898"},"PeriodicalIF":3.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201923","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":"Long-Stay Psychiatric Inpatients With and Without Intellectual and Developmental Disabilities: An Ontario Population-Based Study: Patients hospitalisés pour de longs séjours en psychiatrie avec ou sans déficiences intellectuelles et développementales,: Une étude fondée sur la population de l'Ontario.","authors":"Avra Selick, Michael A Campitelli, Anjie Huang, Robert Balogh, Paul Kurdyak, Yona Lunsky","doi":"10.1177/07067437251380731","DOIUrl":"10.1177/07067437251380731","url":null,"abstract":"<p><p>ObjectivePatients with intellectual and developmental disabilities (IDDs) and psychiatric disorders are at higher risk for prolonged hospitalisations. The aim of this study was to examine the prevalence of IDD among long-stay inpatients in Ontario psychiatric beds, and compare the demographic and clinical profiles of long-stay inpatients with and without IDD.MethodsThis Ontario population-based cross-sectional study used linked health administrative databases. All patients over 18 years of age occupying a non-forensic psychiatric inpatient bed in Ontario on September 30th, 2023 were included in the analysis. We examined prevalence of IDD among patients with a length of stay (LOS) ≥ 365 days ('long-stay patients'). Standardised differences were used to compare demographic, clinical, functional, and health care utilisation characteristics between patients with and without IDD.ResultsOf the 1,466 long-stay patients in an Ontario non-forensic psychiatric inpatient bed, 22.0% had IDD. They were younger (mean age 44.3 vs. 47.6) and a higher proportion were male (64.3% vs. 50.1%). In the 2 years prior to admission, a higher proportion of long-stay patients with IDD had a psychotic disorder (73.3% vs. 54.0%), and they had a higher median number of ED visits (5 vs. 3). Long-stay inpatients with IDD were more likely to have difficulty with activities of daily living (39.8% vs. 15.0%), moderate/severe cognitive impairment (63.0% vs. 29.9%) and fewer social contacts in place to support discharge (59.3% vs. 48.6%). While in hospital, a greater proportion of long-stay patients with IDD were subject to restraints (12.4% vs. 8.0%) and seclusion (20.2% vs. 11.2%).ConclusionsAdults with IDD account for more than one in five long-stay psychiatric inpatients and have unique needs including greater cognitive impairment and difficulty caring for themselves. Successful transitions out of hospital require specialised resources and cross-sectoral collaboration.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251380731"},"PeriodicalIF":3.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187774","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}