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

{"title":"Canadian Guidelines for Forensic Psychiatry Assessments and Report Writing—Executive Summary.","authors":"Lisa A L Ramshaw, Sumeeta Chatterjee, Todd Tomita, Graham D Glancy, Treena D Wilkie","doi":"10.1177/07067437231200843","DOIUrl":"10.1177/07067437231200843","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"165-168"},"PeriodicalIF":4.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184205","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":"[Obstacles and practical perspectives of the consultation in general medicine of migrants with psychological disorders. Qualitative study among French general practitioners].","authors":"Marie Lerigoleur, Aurélie Urena-Dores, Bourrel Gérard, Cyril Jaume, Mathilde Minet, Élodie Million, Bernard Clary, Agnès Oude Engberink, Béatrice Lognos Folco","doi":"10.1177/07067437231200842","DOIUrl":"10.1177/07067437231200842","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to understand the problems of managing psychological disorders in migrant populations, based on the experience of general practitioners.</p><p><strong>Method: </strong>A qualitative study was carried out with general practitioners interviewed in a semi-directive mode. We chose the continuous comparison method and Peirce's pragmatic phenomenological approach to explore the lived experience.</p><p><strong>Results: </strong>Thirteen interviews revealed four phenomenological categories: (1) Immigration was an experience of mental suffering from beginning to end at the source of psychological disorder migrant population (PDMPs) with the need for specialized follow-up. (2) Inadequate support on arrival, with complicated administrative procedures and insecure societal and environmental conditions, exacerbated the precariousness of migrants, making follow-up difficult. (3) Immigration was a transcultural journey in which the language, attitudes and perceptions of each individual blurred understanding of symptoms and care, and thus professional communication. (4) Unprepared general practitioners found counselling migrants to be difficult, time-consuming and complex. They pointed to the need for a coordinated system with comprehensive multidisciplinary care.Data saturation was reached. Three researchers were brought together.</p><p><strong>Conclusion: </strong>This study highlights the difficulties encountered by general practitioner (GPs) dealing with migrant patients in France. They feel helpless in the face of the nature of the disorders encountered and experience a disparity between the connections that are difficult to establish and those in their usual practice, even when professional experience with this population is acquired. They point to the need for coordinated models of care, financed by public policy.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"207-216"},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173248","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":"Chronic Psychotic Disorders and Correctional Involvement: A Population-Based Matched Case-Control Study in Ontario, Canada.","authors":"Ruchi Vijh, Fiona G Kouyoumdjian, Tomisin Iwajomo, Alexander I F Simpson, Roland Jones, Claire de Oliveira, Paul Kurdyak","doi":"10.1177/07067437231189468","DOIUrl":"10.1177/07067437231189468","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with chronic psychotic disorders are overrepresented in correctional facilities, but little is known about factors that increase the risk of correctional involvement. The objective of this study was to compare individuals with chronic psychotic disorders who were released from correctional facilities in Ontario to individuals with chronic psychotic disorders but no correctional involvement on sociodemographic, clinical, and prior mental health-related health service utilization characteristics.</p><p><strong>Method: </strong>All individuals with chronic psychotic disorders who were released from a provincial correctional facility in Ontario in 2010 were matched (1:2) by age and sex to Ontario residents with chronic psychotic disorders and no correctional involvement. Covariates included sociodemographic (rural residence, marginalization such as residential instability quintile, material deprivation quintile, dependency quintile, and ethnic concentration quintile) and clinical (duration of chronic psychotic disorder and comorbidities) characteristics, and mental health-related health service utilization characteristics (primary care physician, psychiatrist and emergency department visits, and hospitalizations) 1 and 3 years prior to correctional involvement. The association between correctional involvement and prior health service utilization was measured by estimating incidence rate ratios using Poisson and negative-binomial regressions.</p><p><strong>Results: </strong>Individuals with correctional involvement (<i>N</i> = 3,197) lived in neighbourhoods with higher material deprivation and residential instability, and had a shorter duration of illness, and more psychosocial comorbidities (e.g., behavioural issues and depression) than individuals without correctional involvement (<i>N</i> = 6,393). Adjusting for sociodemographic and clinical variables, individuals with correctional involvement had a higher rate of mental health-related primary care physician visits, emergency department visits, and hospitalizations but a lower rate of psychiatrist visits prior to correctional involvement, compared to individuals without correctional involvement.</p><p><strong>Conclusions: </strong>Despite higher mental health-related comorbidities and higher rates of accessing acute mental health services among individuals with chronic psychotic disorders and correctional involvement, visits to psychiatrists prior to involvement were low.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"196-206"},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881288","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":"Shifting Mindsets: The Impact of a Patient Portal on Functioning and Recovery in a Mental Health Setting.","authors":"Brian Lo, Hwayeon Danielle Shin, Jessica Kemp, Mikayla Munnery, Sheng Chen, Clement Ma, Damian Jankowicz, Rohan Mehta, Alexandra Harris, Moshe Sakal, Ryan Pundit, Kevin Chung, Craig Kuziemsky, Sarah Rossetti, Gillian Strudwick","doi":"10.1177/07067437231197060","DOIUrl":"10.1177/07067437231197060","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to understand whether higher use of a patient portal can have an impact on mental health functioning and recovery.</p><p><strong>Method: </strong>A mixed methods approach was used for this study. In 2019-2021, patients with mental health diagnoses at outpatient clinics in an academic centre were invited to complete World Health Organization Disability Assessment Scale 12 (WHODAS-12) and Mental Health Recovery Measure surveys at baseline, 3 months, and 6 months after signing up for the portal. At the 3-month time point, patients were invited to a semistructured interview with a member of the team to contextualize the findings obtained from the surveys. Analytics data was also collected from the platform to understand usage patterns on the portal.</p><p><strong>Results: </strong>Overall, 113 participants were included in the analysis. There was no significant change in mental health functioning and recovery scores over the 6-month period. However, suboptimal usage was observed as 46% of participants did not complete any tasks within the portal. Thirty-five participants had low use of the portal (1-9 interactions) and 18 participants had high usage (10+ interactions). There were also no differences in mental health functioning and recovery scores between low and high users of the portal. Qualitative interviews highlighted many opportunities where the portal can support overall functioning and mental health recovery.</p><p><strong>Conclusions: </strong>Collectively, this study suggests that higher use of a portal had no impact, either positive or negative, on mental health outcomes. While it may offer convenience and improved patient satisfaction, adequate support is needed to fully enable these opportunities for patient care. As the type of interaction with the portal was not specifically addressed, future work should focus on looking at ways to support patient engagement and portal usage throughout their care journey.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"217-227"},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10115276","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 Association Between Self-Reported Anxiety and Retention in Opioid Agonist Therapy: Findings From a Canadian Pragmatic Trial.","authors":"Anees Bahji, Gabriel Bastien, Paxton Bach, JinCheol Choi, Bernard Le Foll, Ron Lim, Didier Jutras-Aswad, M Eugenia Socias","doi":"10.1177/07067437231194385","DOIUrl":"10.1177/07067437231194385","url":null,"abstract":"<p><strong>Background: </strong>Prescription-type opioid use disorder (POUD) is often accompanied by comorbid anxiety, yet the impact of anxiety on retention in opioid agonist therapy (OAT) is unclear. Therefore, this study investigated whether baseline anxiety severity affects retention in OAT and whether this effect differs by OAT type (methadone maintenance therapy (MMT) vs. buprenorphine/naloxone (BNX)).</p><p><strong>Methods: </strong>This secondary analysis used data from a pan-Canadian randomized trial comparing flexible take-home dosing BNX and standard supervised MMT for 24 weeks. The study included 268 adults with POUD. Baseline anxiety was assessed using the Beck Anxiety Inventory (BAI), with BAI ≥ 16 indicating moderate-to-severe anxiety. The primary outcomes were retention in assigned and any OAT at week 24. In addition, the impact of anxiety severity on retention was examined, and assigned OAT was considered an effect modifier.</p><p><strong>Results: </strong>Of the participants, 176 (65%) reported moderate-to-severe baseline anxiety. In adjusted analyses, there was no significant difference in retention between those with BAI ≥ 16 and those with BAI < 16 assigned (29% vs. 28%; odds ratio (OR) = 2.03, 95% confidence interval (CI) = 0.94-4.40; <i>P</i> = 0.07) or any OAT (35% vs. 34%; OR = 1.57, 95% CI = 0.77-3.21; <i>P</i> = 0.21). In addition, there was no significant effect modification by OAT type for retention in assigned (<i>P</i> = 0.41) or any OAT (<i>P</i> = 0.71). In adjusted analyses, greater retention in treatment was associated with BNX (vs. MMT), male gender identity (vs. female, transgender, or other), enrolment in the Quebec study site (vs. other sites), and absence of a positive urine drug screen for stimulants at baseline.</p><p><strong>Conclusions: </strong>Baseline anxiety severity did not significantly impact retention in OAT for adults with POUD, and there was no significant effect modification by OAT type. However, the overall retention rates were low, highlighting the need to develop new strategies to minimize the risk of attrition from treatment.</p><p><strong>Clinical trial registration: </strong>This study was registered in ClinicalTrials.gov (NCT03033732).</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"172-182"},"PeriodicalIF":4.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10204227","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":"Influence of <i>CYP2C19</i>, <i>CYP2D6</i>, and <i>ABCB1</i> Gene Variants and Serum Levels of Escitalopram and Aripiprazole on Treatment-Emergent Sexual Dysfunction: A Canadian Biomarker Integration Network in Depression 1 (CAN-BIND 1) Study.","authors":"Farhana Islam, Leen Magarbeh, Samar S M Elsheikh, Stefan Kloiber, Caroline W Espinola, Venkat Bhat, Benicio N Frey, Roumen Milev, Claudio N Soares, Sagar V Parikh, Franca Placenza, Stefanie Hassel, Valerie H Taylor, Francesco Leri, Pierre Blier, Rudolf Uher, Faranak Farzan, Raymond W Lam, Gustavo Turecki, Jane A Foster, Susan Rotzinger, Sidney H Kennedy, Daniel J Müller","doi":"10.1177/07067437231203433","DOIUrl":"10.1177/07067437231203433","url":null,"abstract":"<p><strong>Objectives: </strong>Treatment-emergent sexual dysfunction is frequently reported by individuals with major depressive disorder (MDD) on antidepressants, which negatively impacts treatment adherence and efficacy. We investigated the association of polymorphisms in pharmacokinetic genes encoding cytochrome-P450 drug-metabolizing enzymes, <i>CYP2C19</i> and <i>CYP2D6</i>, and the transmembrane efflux pump, P-glycoprotein (i.e., <i>ABCB1</i>), on treatment-emergent changes in sexual function (SF) and sexual satisfaction (SS) in the Canadian Biomarker Integration Network in Depression 1 (CAN-BIND-1) sample.</p><p><strong>Methods: </strong>A total of 178 adults with MDD received treatment with escitalopram (ESC) from weeks 0-8 (Phase I). At week 8, nonresponders were augmented with aripiprazole (ARI) (i.e., ESC + ARI, <i>n</i> = 91), while responders continued ESC (i.e., ESC-Only, <i>n</i> = 80) from weeks 8-16 (Phase II). SF and SS were evaluated using the sex effects (SexFX) scale at weeks 0, 8, and 16. We assessed the primary outcomes, SF and SS change for weeks 0-8 and 8-16, using repeated measures mixed-effects models.</p><p><strong>Results: </strong>In ESC-Only, <i>CYP2C19</i> intermediate metabolizer (IM) + poor metabolizers (PMs) showed treatment-related improvements in sexual arousal, a subdomain of SF, from weeks 8-16, relative to <i>CYP2C19</i> normal metabolizers (NMs) who showed a decline, <i>F</i>(2,54) = 8.00, <i>p </i>< 0.001, <i>q </i>= 0.048. Specifically, <i>CYP2C19</i> IM + PMs reported less difficulty with having and sustaining vaginal lubrication in females and erection in males, compared to NMs. Furthermore, ESC-Only females with higher concentrations of ESC metabolite, S-desmethylcitalopram (S-DCT), and S-DCT/ESC ratio in serum demonstrated more decline in SF (<i>r</i> = -0.42, <i>p </i>= 0.004, <i>q </i>= 0.034) and SS (<i>r</i> = -0.43, <i>p </i>= 0.003, <i>q </i>= 0.034), respectively, which was not observed in males. ESC-Only females also demonstrated a trend for a correlation between S-DCT and sexual arousal change in the same direction (<i>r</i> = -0.39, <i>p </i>= 0.009, <i>q </i>= 0.052).</p><p><strong>Conclusions: </strong><i>CYP2C19</i> metabolizer phenotypes may be influencing changes in sexual arousal related to ESC monotherapy. Thus, preemptive genotyping of <i>CYP2C19</i> may help to guide selection of treatment that circumvents selective serotonin reuptake inhibitor-related sexual dysfunction thereby improving outcomes for patients. Additionally, further research is warranted to clarify the role of S-DCT in the mechanisms underlying ESC-related changes in SF and SS. This CAN-BIND-1 study was registered on clinicaltrials.gov (Identifier: NCT01655706) on 27 July 2012.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"183-195"},"PeriodicalIF":4.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121377","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":"Factors Associated with Transition to Serious Mental Illness.","authors":"Sara Jalali, Lu Liu, JianLi Wang, Sidney H Kennedy, Glenda MacQueen, Catherine Lebel, Benjamin L Goldstein, Signe Bray, Jean Addington","doi":"10.1177/07067437231195959","DOIUrl":"10.1177/07067437231195959","url":null,"abstract":"<p><strong>Objective: </strong>There is increasing interest in early intervention and detection strategies for youth at-risk of developing a serious mental illness (SMI). Little is known about early factors that may be related to the later development of a SMI; thus, the aim of this study was to determine what clinical factors might relate to the development of in this study psychosis, bipolar disorder and severe or recurrent major depression in at-risk youth.</p><p><strong>Method: </strong>The sample consisted of 162 youth aged 12-26 years at different stages of risk. Thirty-one participants developed a SMI during the study. Those who made a transition were compared on a range of baseline clinical and functional measures with those who did not make the transition. A Cox regression model was used to assess the association between measures and later development of a SMI.</p><p><strong>Results: </strong>Female sex, attenuated psychotic symptoms as assessed with the Scale of Psychosis-Risk Symptoms (SOPS) and ratings on the K-10 Distress Scale, were found to be significantly associated with the later transition to mental illness. Females were 2.77 times more likely to transition compared to males. For the SOPS and K-10 scales, there is a 14% increase in the transition rate relative to a one-scale increase in SOPS and a 7% increase in the transition rate relative to a one-point increase in the K-10.</p><p><strong>Conclusions: </strong>Results from these longitudinal data provide further insight into the specific clinical measures that may be pertinent in early detection of mental illnesses.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"79-88"},"PeriodicalIF":3.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10048172","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":"Predictors of Physician Follow-Up Care Among Patients Affected by an Incident Mental Disorder Episode in Quebec (Canada).","authors":"Marie-Josée Fleury, Louis Rochette, Lia Gentil, Guy Grenier, Alain Lesage","doi":"10.1177/07067437231182570","DOIUrl":"10.1177/07067437231182570","url":null,"abstract":"<p><strong>Objectives: </strong>This study identified predictors of prompt (1+ outpatient physician consultations/within 30 days), adequate (3+/90 days) and continuous (5+/365 days) follow-up care from general practitioners (GPs) or psychiatrists among patients with an incident mental disorder (MD) episode.</p><p><strong>Methods: </strong>Study data were extracted from the Quebec Integrated Chronic Disease Surveillance System (QICDSS), which covers 98% of the population eligible for health-care services under the Quebec (Canada) Health Insurance Plan. This observational epidemiological study investigating the QICDSS from 1 April 1997 to 31 March 2020, is based on a 23-year patient cohort including 12+ years old patients with an incident MD episode (<i>n</i> = 2,670,133). Risk ratios were calculated using Robust Poisson regressions to measure patient sociodemographic and clinical characteristics, and prior service use, which predicted patients being more or less likely to receive prompt, adequate, or continuous follow-up care after their last incident MD episode, controlling for previous MD episodes, co-occurring disorders, and years of entry into the cohort.</p><p><strong>Results: </strong>A minority of patients, and fewer over time, received physician follow-up care after an incident MD episode. Women; patients aged 18-64; with depressive or bipolar disorders, co-occurring MDs-substance-related disorders (SRDs) or physical illnesses; those receiving previous GP follow-up care, especially in family medicine groups; patients with higher prior continuity of GP care; and previous high users of emergency departments were more likely to receive follow-up care. Patients living outside the Montreal metropolitan area; those without prior MDs; patients with anxiety, attention deficit hyperactivity, personality, schizophrenia and other psychotic disorders, or SRDs were less likely to receive follow-up care.</p><p><strong>Conclusion: </strong>This study shows that vulnerable patients with complex clinical characteristics and those with better previous GP care were more likely to receive prompt, adequate or continuous follow-up care after an incident MD episode. Overall, physician follow-up care should be greatly improved.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"100-115"},"PeriodicalIF":3.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10584576","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 Rapid Access Brief Psychotherapy Intervention to Respond to Healthcare Workers in Ontario Whose Mental Health was Negatively Impacted During the COVID-19 Pandemic.","authors":"Judith M Laposa, Duncan Cameron, Kim Corace, Natalie Quick, Karen Rowa, Cary Kogan, Stephanie Carter, Irena Milosevic, Sara de la Salle, Vicky Stergiopoulos, Joseph Pellizzari, Erika Haber, Paul Kurdyak, Randi E McCabe","doi":"10.1177/07067437231187462","DOIUrl":"10.1177/07067437231187462","url":null,"abstract":"<p><strong>Objective: </strong>Although the coronavirus disease 2019 (COVID-19) pandemic has had widespread negative impacts on the mental health of healthcare workers (HCWs), there has been little research on psychological interventions during the pandemic for this population. The current study examines whether a brief coping-focused treatment intervention delivered in a virtual individual format would be associated with positive changes in Canadian HCWs' mental health during the pandemic.</p><p><strong>Method: </strong>Three hundred and thirty-three HCWs receiving the intervention at 3 large specialty tertiary care hospitals in Ontario, Canada, completed measures of anxiety, depression, perceived stress, work/social impairment, insomnia and fear of COVID-19. After completing treatment, HCWs rated their satisfaction with the treatment.</p><p><strong>Results: </strong>The intervention was associated with large effect size improvements in anxiety, depression, perceived stress, insomnia and fear of COVID-19, and moderate effect size improvements in work/social impairment. At treatment session 1, prior mental health diagnosis and treatment were both significantly correlated with depression, anxiety, and work/social impairment scores. Secondary analyses of data from one of the sites revealed that treatment-related changes in anxiety, depression, perceived stress and work/social impairment were independent of age, gender, occupational setting, profession and the presence of a previous mental health diagnosis or treatment, with the exception that nurses improved at a slightly greater rate than other professions in terms of work/social impairment. HCWs were highly satisfied with the treatment.</p><p><strong>Conclusions: </strong>A large number of HCWs experiencing significant distress at baseline self-referred for assistance. Timely and flexible access to a brief virtual coping-focused intervention was associated with improvements in symptoms and impairment, and treatment response was largely unrelated to demographic or professional characteristics. Short-term psychological interventions for HCWs during a pandemic may have a highly positive impact given their association with improvement in various aspects of HCWs' mental health improvement.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"89-99"},"PeriodicalIF":4.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10345831/pdf/10.1177_07067437231187462.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783863","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":"Child Maltreatment History, Deployment-Related Traumatic Events, and Past 12-Month Cannabis Use Among Veterans in Canada.","authors":"Tracie O Afifi, Tamara Taillieu, Samantha Salmon, Ashley Stewart-Tufescu, Jitender Sareen, Murray W Enns, Natalie Mota, Shay-Lee Bolton, R Nicholas Carleton, Alexandra Heber, Linda VanTil","doi":"10.1177/07067437231192740","DOIUrl":"10.1177/07067437231192740","url":null,"abstract":"<p><strong>Objective: </strong>Cannabis use among veterans in Canada is an understudied public health priority. The current study examined cannabis use prevalence and the relationships between child maltreatment histories and deployment-related traumatic events (DRTEs) with past 12-month cannabis use including sex differences among Canadian veterans.</p><p><strong>Method: </strong>Data were drawn from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (response rate 68.7%; veterans only <i>n</i> = 1,992). Five child maltreatment types and 9 types of DRTEs were assessed in relation to the past 12-month cannabis use.</p><p><strong>Results: </strong>The prevalence of lifetime and past 12-month cannabis use was 49.4% and 16.7%, respectively. Females were less likely than males to report lifetime cannabis use (41.9% vs. 50.4%; odds ratio [OR] 0.71; 95% CI, - 0.59 to 0.86). No sex differences were noted for past 12-month cannabis use (14.1% vs. 17.0%; OR 0.80; 95% CI, 0.60 to 1.07). Physical abuse, sexual abuse, neglect, any child maltreatment, most individual DRTEs, and any DRTE were associated with increased odds of past 12-month cannabis use after adjusting for sociodemographic and military variables. Some models were attenuated and/or nonsignificant after further adjustments for mental disorders and chronic pain conditions. Sex did not statistically significantly moderate these relationships. Cumulative effects of having experienced both child maltreatment and DRTEs compared to DRTEs alone increased the odds of past 12-month cannabis use. Statistically significant interaction effects between child maltreatment history and DRTE on cannabis use were not found.</p><p><strong>Conclusions: </strong>Child maltreatment histories and DRTEs increased the likelihood of past 12-month cannabis use among Canadian veterans. A history of child maltreatment, compared to DRTEs, indicated a more robust relationship. Understanding the links between child maltreatment, DRTEs, and cannabis use along with mental disorders and chronic pain conditions is important for developing interventions and improving health outcomes among veterans.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"116-125"},"PeriodicalIF":4.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9977279","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}