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

{"title":"Rethinking Schizophrenia-A Manageable Chronic Condition.","authors":"Robert B Zipursky","doi":"10.1177/07067437241301572","DOIUrl":"10.1177/07067437241301572","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"151-153"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803504","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":"Real-World Treatment of Schizophrenia in Adults With a 22q11.2 Microdeletion: Traitement dans le monde réel de la schizophrénie chez des adultes atteints du syndrome de microdélétion 22q11.2.","authors":"Lily Van, Tracy Heung, Nikolai Gil D Reyes, Erik Boot, Eva W C Chow, Maria Corral, Anne S Bassett","doi":"10.1177/07067437241293983","DOIUrl":"10.1177/07067437241293983","url":null,"abstract":"<p><strong>Objective: </strong>One in every 4 individuals born with a 22q11.2 microdeletion will develop schizophrenia. Thirty years of clinical genetic testing capability have enabled detection of this major molecular susceptibility for psychotic illness. However, there is limited literature on the treatment of schizophrenia in individuals with a 22q11.2 microdeletion, particularly regarding the issue of treatment resistance.</p><p><strong>Methods: </strong>From a large, well-characterized adult cohort with a typical 22q11.2 microdeletion followed for up to 25 years at a specialty clinic, we studied all 107 adults (49 females, 45.8%) meeting the criteria for schizophrenia or schizoaffective disorder. We performed a comprehensive review of lifetime (1,801 patient-years) psychiatric records to determine treatments used and the prevalence of treatment-resistant schizophrenia (TRS). We used Clinical Global Impression-Improvement (CGI-I) scores to compare within-individual responses to clozapine and nonclozapine antipsychotics. For a subgroup with contemporary data (<i>n</i> = 88, 82.2%), we examined antipsychotics and dosage at the last follow-up.</p><p><strong>Results: </strong>Lifetime treatments involved on average 4 different antipsychotic medications per individual. Sixty-three (58.9%) individuals met the study criteria for TRS, a significantly greater proportion than for a community-based comparison (42.9%; χ² = 10.38, df = 1, <i>p </i>< 0.01). The non-TRS group was enriched for individuals with genetic diagnosis before schizophrenia diagnosis. Within-person treatment response in TRS was significantly better for clozapine than for nonclozapine antipsychotics (<i>p </i>< 0.0001). At the last follow-up, clozapine was the most common antipsychotic prescribed, followed by olanzapine, risperidone, and paliperidone. Total antipsychotic chlorpromazine equivalent dosages were in typical clinical ranges (median: 450 mg; interquartile range: 300, 750 mg).</p><p><strong>Conclusion: </strong>The results for this large sample indicate that patients with 22q11.2 microdeletion have an increased propensity to treatment resistance. The findings provide evidence about how genetic diagnosis can inform clinical psychiatric management and could help reduce treatment delays. Further research is needed to shed light on the pathophysiology of antipsychotic response and on strategies to optimize outcomes.</p><p><strong>Plain language summary title: </strong>Real-world treatment of schizophrenia in adults with a 22q11.2 microdeletion.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"160-170"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787766","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":"Formal Thought Disorders and Neurocognition in Treatment-Resistant Schizophrenia: Trouble du cours de la pensée et neurocognition dans la schizophrénie réfractaire.","authors":"Mohammed Alarabi, Leah Burton, Valerie Powell, Tanner Isinger, Sri Mahavir Agarwal, Gary Remington","doi":"10.1177/07067437241293985","DOIUrl":"10.1177/07067437241293985","url":null,"abstract":"<p><strong>Objective: </strong>Formal thought disorders (FTDs), a core feature of schizophrenia, have been subdivided into positive and negative types, and are clinically assessed by examining speech (objective) or patient introspection (subjective). Despite being associated with poorer treatment response and worse outcomes, FTDs have been understudied in patients with schizophrenia, in particular treatment-resistant schizophrenia (TRS) or schizoaffective disorder. We aimed to explore the relationship between the severity of positive and negative FTDs and neurocognition as well as social/occupational functioning in this clinical subgroup.</p><p><strong>Method: </strong>This was a retrospective chart review conducted at the Clozapine Clinic at the Centre for Addiction and Mental Health, Toronto, Canada. We reviewed charted standardized assessment of FTDs using the Thought and Language Disorder (TALD) scale, neurocognition using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), and functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) between October 2022 and June 2023. Following the original factor structure of the TALD, we computed 4- factor scores that combined positive or negative and objective or subjective FTDs. We then explored the correlation between the scores from each TALD factor and the neurocognition and functioning scores.</p><p><strong>Results: </strong>We analysed data for 23 outpatients on clozapine. After the Bonferroni adjustment, total TALD scores, indicating overall severity of FTDs, were strongly and inversely correlated with SOFAS scores (<i>p</i> < 0.001). A strong inverse correlation was found between the objective positive TALD factor and Letter-Number Span verbal working memory scores, <i>r</i>(21) = -0.63, <i>p</i> < 0.001.</p><p><strong>Conclusions: </strong>Our results demonstrate the strong relationship between FTDs, neurocognition, and social/occupational functioning in a sample of TRS outpatients. Within the cognitive domains assessed, verbal working memory impairment had the strongest correlation with positive FTDs, such as derailment or tangentiality. These findings highlight the value of employing standardized psychopathological scales for FTDs in clinical practice.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"229-239"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577160","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":"Cognitive-Behavioural Social Skills Training: Mediation of Treatment Outcomes in a Randomized Controlled Trial for Youth at Risk of Psychosis: L'entraînement aux compétences sociales cognitivo-comportementales : variables médiatrices des résultats thérapeutiques dans le cadre d'un essai clinique randomisé pour les jeunes présentant un risque de psychose.","authors":"Daniel J Devoe, Lu Liu, Amy Braun, Kristin S Cadenhead, Barbara A Cornblatt, Eric Granholm, Jean Addington","doi":"10.1177/07067437241295636","DOIUrl":"10.1177/07067437241295636","url":null,"abstract":"<p><strong>Objectives: </strong>Currently, there are no effective treatments for functional outcomes (i.e., role and social) and negative symptoms for youth at clinical high-risk (CHR) for psychosis. Investigations into possible mechanisms that may contribute to the improvement of functioning and negative symptoms are needed in CHR research to help inform psychosocial treatments. The present study examined whether functioning and negative symptoms were mediated by asocial beliefs, defeatist beliefs, self-efficacy, maladaptive schemas, anxiety, depression, social cognition, or attenuated psychotic symptoms (APS) in a large clinical trial.</p><p><strong>Methods: </strong>CHR participants (<i>n</i> = 203; 104 females; 99 males) were recruited as part of a three-site randomized control trial comparing group cognitive-behavioural social skills training (CBSST) versus a supportive therapy group. Mediation analyses were conducted to test the relationships between treatment group, mediators (asocial beliefs, defeatist beliefs, self-efficacy, maladaptive schemas, anxiety, depression, social cognition, and APS), and outcome (social and role functioning, and negative symptoms). The mediation analyses employed conditional process path analysis via ordinary least squares regression.</p><p><strong>Results: </strong>At the end of treatment, but not 12-month follow-up, more severe APS were found to mediate the impact of treatment on negative symptoms, and social and role functioning. The greater the severity of APS, the less likely that CBSST would result in improvement in negative symptoms and social and role functioning. Many of the other variables showed significant associations with social (less for role) functioning and negative symptoms but did not mediate the effect of treatment on these outcomes at the end of treatment or 12-month follow-up.</p><p><strong>Conclusions: </strong>There were no significant mediators except for APS at the end of treatment. Since more severe APS may result in participants being unable to fully participate in therapy and thus limit their gains, clinical implications may include offering some individual therapy to prepare these young people to benefit from the group treatment.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"217-228"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633262","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":"Limitations and Future Directions in Pharmacological Treatment for Amphetamine-Type Stimulant Use Disorder.","authors":"Anees Bahji","doi":"10.1177/07067437241312683","DOIUrl":"10.1177/07067437241312683","url":null,"abstract":"<p><p>Plain Language Summary<i><b>Why Current Treatments for Stimulant Addiction Often Fall Short: Insights and Future Directions</b></i> Stimulant addiction, such as addiction to drugs like amphetamines, is a growing public health concern, but there are very few effective medications to treat it. A recent study reviewed a drug called modafinil and found it didn't help reduce drug use, cravings, or improve treatment outcomes. This article discusses why treatments that work for other addictions, like opioids, are less effective for stimulants. It also highlights the challenges researchers face, such as differences in study methods and overlooking common issues like mental health problems or using multiple substances. The focus on complete abstinence as a treatment goal is another issue. Harm reduction, which involves reducing drug use and improving health and social well-being, could be more realistic and beneficial for many people. Finally, while therapy remains the most effective treatment, it's not always accessible. This article calls for new, innovative approaches that prioritize harm reduction, safety, and long-term recovery.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"136-137"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016822","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 Time-Series Analysis of News Media Coverage of Suicide in Canada from 2019 to 2023: Une analyse de séries chronologiques de la couverture responsable du suicide par les médias au Canada de 2019 à 2023.","authors":"Juliette Careau, Justin Bélair, Rob Whitley","doi":"10.1177/07067437241309677","DOIUrl":"10.1177/07067437241309677","url":null,"abstract":"<p><strong>Objective: </strong>Evidence suggests that the media can play a role in preventing suicide, as well as contributing to suicide contagion. As such, the primary objective is to assess adherence to responsible reporting of suicide recommendations in news articles about suicide over time. A secondary objective is to assess whether reporting changed significantly during the COVID-19 pandemic. The tertiary objective is to assess overall patterns regarding types of suicide reported.</p><p><strong>Methods: </strong>We collected news articles with the keyword \"suicide\" from 47 Canadian news sources between April 1, 2019, and March 31, 2023. Articles were coded for adherence to key responsible reporting of suicide guidelines. Frequency counts and percentages of adherence were calculated for all key variables. Time series analyses using a Generalized Linear Autoregressive Moving Average model assessed for adherence trends over time, including measuring for any changes during the COVID-19 years.</p><p><strong>Results: </strong>Study procedures resulted in 3,232 coded news articles. Overall, the results indicate that adherence to the guidelines has moderately improved over the course of the 4-year period. This is especially true for recommendations regarding avoiding putatively harmful content, such as detailed descriptions of the suicide method. Similar improvements were seen in adherence to guidelines related to the inclusion of putatively helpful content, with significantly more articles providing help-seeking information. However, in the final year of the study, less than a third of articles included educational content about suicide, help-seeking information, or quotes from suicide experts. Reporting of suicide during the COVID-19 period showed some positive improvements; however, these were not sustained after the pandemic ended.</p><p><strong>Conclusions: </strong>On the plus side, adherence to responsible suicide reporting guidelines improved over the 4-year period, especially for recommendations concerning putatively helpful content. However, there remains room for improvement regarding the inclusion of putatively protective content such as including help-seeking information, educating about suicide, and quoting experts.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"98-108"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958672","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":"Sex-stratified Genomic Structural Equation Models of Posttraumatic Stress Inform PTSD Etiology: L'utilisation de la modélisation génomique par équations structurelles stratifiée par sexe du stress post-traumatique pour expliquer l'étiologie du TSPT.","authors":"Ashley Moo-Choy, Murray B Stein, Joel Gelernter, Frank R Wendt","doi":"10.1177/07067437241301016","DOIUrl":"10.1177/07067437241301016","url":null,"abstract":"<p><strong>Objective: </strong>Posttraumatic stress disorder (PTSD) affects 3.9%-5.6% of the worldwide population, with well-documented sex-related differences. While psychosocial and hormonal factors affecting sex differences in PTSD and posttraumatic stress (PTS) symptom etiology have been explored, there has been limited focus on the genetic bases of these differences. Many symptom combinations may confer a PTSD diagnosis. We hypothesized that these symptom combinations have sex-specific patterns, the examination of which could inform etiological differences in PTSD genetics between males and females.</p><p><strong>Methods: </strong>To investigate this, we performed a sex-stratified multivariate genome-wide association study (GWAS) in unrelated UK Biobank (UKB) individuals of European ancestry. Using GWAS summary association data, genomic structural equation modelling was performed to generate sex-specific factor models using 6 indicator variables: trouble concentrating, feeling distant from others, irritability, disturbing thoughts, upset feelings, and avoidance of places/activities which remind the individual of a traumatic event.</p><p><strong>Results: </strong>Models of male and female PTSD symptoms differed substantially (local standardized root mean square difference = 3.12) and significantly (χ²(5) = 28.03, <i>P</i> = 3.6 × 10^-5). Independent 2-factor models best fit the data in both males and females; these factors were subjected to GWAS in each sex, revealing 3 genome-wide significant loci in females, mapping to <i>SCAND3</i>, <i>WDPCP</i>, and <i>FAM120A</i>. No genome-wide significant loci were identified in males. All 4 PTS factors (2 in males and 2 in females) were heritable.</p><p><strong>Conclusions: </strong>By assessing the relationship between sex and PTSD symptoms, this study informs correlative and putatively causal etiological differences between males and females which support further investigation of sex differences in PTSD genetics.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"117-126"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803508","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":"Validation de L’échelle Unidimensionnelle D’Estime de Soi de Ducher (ESD): Validation of Ducher's Unidimensional Self-Esteem Scale (SES).","authors":"I de Chazeron, J-L Ducher, M Renoux, G Brousse, P-M Llorca","doi":"10.1177/07067437241301712","DOIUrl":"10.1177/07067437241301712","url":null,"abstract":"<p><strong>Background: </strong>Although self-esteem is a relatively new concept, first developed in the field of social psychology, it has gained increasing importance in psychiatry, especially as a diagnostic criterion. However, it is poorly evaluated in clinical practice. The lack of an instrument allowing an easy global assessment may be the reason for this. It is therefore a question of validating a short, one-dimensional self-esteem scale in French, possibly allowing an evolutionary follow-up by self-correction.</p><p><strong>Methods: </strong>The study involved 106 patients with various psychiatric disorders, except psychotic disorder, stabilized or of varying severity. The creation of the original tool included 10 items. It was submitted to the selection of items followed by an exploratory factor analysis. The correlation between the items and the measurement of consistency and convergent validity were then performed.</p><p><strong>Result: </strong>The evaluation of acceptability and distribution of results led to the selection of 6 items. Exploratory factor analysis revealed a unique dimension and good reliability (Tucker-Lewis Index = 0.89). No item displays correlations with a total score of less than 0.50 and the concept of construct is consistent. There is also a good internal consistency which confirms that the 6-item ESD version is optimal.</p><p><strong>Conclusion: </strong>This new, validated scale will allow therapists to more accurately investigate the notion of self-esteem in a clinical or research setting.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"109-116"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958807","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":"High Intensity Physician-Based Service Use for Mental Health Concerns in a General-Population Sample of Children and Youth: Utilisation des services de haute intensité dispensés par des médecins pour les problèmes de santé mentale dans un échantillon d'enfants et de jeunes de la population générale.","authors":"Jordan Edwards, Li Wang, Anne E Fuller, Kelly K Anderson, Claire de Oliveira, Katholiki Georgiades","doi":"10.1177/07067437241300961","DOIUrl":"10.1177/07067437241300961","url":null,"abstract":"<p><strong>Objective: </strong>To examine factors associated with high intensity physician-based mental health care services in a population-based sample of children and youth in Ontario, Canada.</p><p><strong>Methods: </strong>Data from the 2014 Ontario Child Health Study (OCHS) were linked at the person-level to longitudinal health administrative databases containing physician contacts in outpatient settings, emergency departments and hospitals. Our analytical sample (15.8% of 9,301, <i>n</i> = 1,423) included children and youth with at least one physician-based contact for a mental health concern in the 24-month period post-OCHS. Over the same follow-up period, we classified high intensity service use as those in the top 10th and fifth percentiles of physician-based mental health service cost contributors. Costs were assessed using physician billing data, as well as estimated emergency department visit and hospitalization costs.</p><p><strong>Results: </strong>Among those with at least one contact, being older (PR: 1.15, 95% CI: 1.04, 1.25), having more severe symptoms of mental ill-health (PR: 1.04, 95% CI: 1.01, 1.06) and having a history of mental health service use (PR: 3.99, 95% CI: 1.37, 11.61), were positively associated with high-intensity service use, while living in a rural setting (PR: 0.35, 95% CI: 0.15, 0.30) was negatively associated. Findings were largely consistent between the top 10th and fifth percentiles. Notably, among youth ages 14-17 years, self-reported prior suicide attempt was positively associated with high-intensity (top fifth percentile) service use (PR: 6.09, 95% CI: 1.41, 26.26).</p><p><strong>Conclusions: </strong>Our findings suggest older age, non-rural residency, mental health symptom severity and suicidal behaviour are important factors associated with high-intensity physician-based mental health service use. Our findings will inform efforts to better identify children and youth who may benefit from early and personalized interventions.</p><p><strong>Plain language summary title: </strong>Understanding Children and Youth with the Greatest Mental Health Related Service Needs.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"127-135"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984132","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":"Strategies for Achieving Better Cognitive Health in Individuals with Schizophrenia Spectrum: A Focus on the Canadian Landscape: Stratégies pour atteindre une meilleure santé cognitive chez les personnes souffrant du spectre de la schizophrénie : un regard sur le paysage canadien.","authors":"Martin Lepage, Synthia Guimond, Thomas Raedler, Heather E McNeely, Thomas Ungar, Howard C Margolese, Michael Best","doi":"10.1177/07067437241261928","DOIUrl":"10.1177/07067437241261928","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia spectrum disorders (SSDs) are a group of psychiatric disorders characterized by positive and negative symptoms as well as cognitive impairment that can significantly affect daily functioning.</p><p><strong>Method: </strong>We reviewed evidence-based strategies for improving cognitive function in patients with SSDs, focusing on the Canadian landscape.</p><p><strong>Results: </strong>Although antipsychotic medications can address the positive symptoms of SSDs, cognitive symptoms often persist, causing functional impairment and reduced quality of life. Moreover, cognitive function in patients with SSDs is infrequently assessed in clinical practice, and evidence-based recommendations for addressing cognitive impairment in people living with schizophrenia are limited. While cognitive remediation (CR) can improve several domains of cognitive function, most individuals with SSDs are currently not offered such an intervention. While the development of implementation strategies for CR is underway, available and emerging pharmacological treatments may help overcome the limited capacity for psychosocial approaches. Furthermore, combining pharmacological with non-pharmacological interventions may improve outcomes compared to pharmacotherapy or CR alone.</p><p><strong>Conclusion: </strong>This review highlights the challenges and discusses the potential solutions related to the assessment and management of cognitive impairment to help mental health-care practitioners better manage cognitive impairment and improve daily functioning in individuals with SSDs.</p><p><strong>Plain language summary title: </strong>Improving Thinking Skills in People With Schizophrenia: A Focus on Canada.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"85-97"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762841","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}