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

{"title":"Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis.","authors":"Agnès Belkacem, Katie M Lavigne, Carolina Makowski, Mallar Chakravarty, Ridha Joober, Ashok Malla, Jai Shah, Martin Lepage","doi":"10.1177/07067437231179161","DOIUrl":"10.1177/07067437231179161","url":null,"abstract":"<p><strong>Objectives: </strong>Antipsychotics are widely used to treat first-episode psychosis but may have an anticholinergic burden, that is, a cumulative effect of medications that block the cholinergic system. Studies suggest that a high anticholinergic burden negatively affects memory in psychosis, where cognitive deficits, particularly those in verbal memory, are a core feature of the disease. The present study sought to replicate this in a large cohort of well-characterized first-episode psychosis patients. We expected that patients in the highest anticholinergic burden group would exhibit the poorest verbal memory compared to those with low anticholinergic burden and healthy controls at baseline (3 months following admission). We further hypothesized that over time, at month 12, patients' verbal memory performance would improve but would remain inferior to controls.</p><p><strong>Methods: </strong>Patients (<i>n</i>  =  311; low anticholinergic burden [<i>n</i>  =  241] and high anticholinergic burden [<i>n</i>  =  70], defined by a Drug Burden Index cut-off of 1) and healthy controls (<i>n</i>  =  128) completed a clinical and neurocognitive battery including parts of the Wechsler Memory Scale at months 3 and 12.</p><p><strong>Results: </strong>Cross-sectionally, using an analysis of variance, patients in the highest anticholinergic burden group had the poorest performance in verbal memory when compared to the other groups at month 3, <i>F</i>(2,430)  =  52.33, <i>P</i> < 0.001. Longitudinally, using a Generalized Estimating Equation model, the verbal memory performance of all groups improved over time. However, patients' performance overall remained poorer than the controls.</p><p><strong>Conclusion: </strong>These findings highlight the importance of considering the anticholinergic burden when prescribing medications in the early stages of the disease.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"894-903"},"PeriodicalIF":4.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9918603","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":"Surveillance of Child and Youth Mental Disorders and Associated Service Use in Canada.","authors":"Jordan Edwards,&nbsp;Paul Kurdyak,&nbsp;Charlotte Waddell,&nbsp;Scott B Patten,&nbsp;Graham J Reid,&nbsp;Leslie Anne Campbell,&nbsp;Katholiki Georgiade","doi":"10.1177/07067437231182059","DOIUrl":"10.1177/07067437231182059","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"819-825"},"PeriodicalIF":4.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10091472","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":"Heterogeneity in the Course of Suicidal Ideation and its Relation to Suicide Attempts in First-Episode Psychosis: A 5-Year Prospective Study.","authors":"Roxanne Sicotte,&nbsp;Srividya N Iyer,&nbsp;Éric Lacourse,&nbsp;Jean R Séguin,&nbsp;Amal Abdel-Baki","doi":"10.1177/07067437231167387","DOIUrl":"10.1177/07067437231167387","url":null,"abstract":"<p><strong>Objectives: </strong>Although the risk of suicide is high in first-episode psychosis (FEP), little is known about the course of suicidal ideation and its relation to suicide attempts. Therefore, we aimed to identify 5-year trajectories of suicidal ideation and associated factors in FEP and compare how suicide attempts were distributed across these identified trajectories.</p><p><strong>Method: </strong>This 5-year prospective study assessed suicidal ideation, suicide attempts and potentially associated factors through research interviews, chart review and coroners' reports in 382 FEP patients [mean age = 23.53 (<i>SD</i> = 3.61)] admitted to 2 5-year early psychosis services in Montreal, Canada. Trajectories were identified using a semiparametric mixture model, and associated factors with multinomial logistic regression.</p><p><strong>Results: </strong>Three suicidal ideation trajectories were identified: <i>low and decreasing</i> (<i>n</i> = 325, 85.08%); <i>early decline, then increasing</i> (<i>n</i> = 30, 7.85%), and <i>persistent suicidal ideation</i> (<i>n</i> = 27, 7.07%). Suicidal ideation prior to admission (OR = 2.85, 95% CI, 1.23 to 6.63, <i>P </i>< 0.05) and cocaine use disorder (OR = 6.78, 95% CI, 1.08 to 42.75, <i>P </i>< 0.05) were associated with the <i>early decline, then increasing suicidal ideation</i> trajectory. Persons with prior suicide ideation (OR = 4.33, 95% CI, 1.66 to 11.29, <i>P </i>< 0.05) and attempts (OR = 8.18, 95% CI, 2.39 to 27.97, <i>P </i>< 0.001) and alcohol use disorder (OR = 3.63, 95% CI, 1.4 to 9.42, <i>P </i>< 0.05) were more likely to belong to the <i>persistent suicidal ideation</i> trajectory, and to attempt suicide during follow-up.</p><p><strong>Conclusions: </strong>Our study highlights heterogeneity in the course of suicidal ideation over 5 years and the importance of ongoing assessment of suicidal risk in FEP patients, particularly for patients who persistently report suicidal ideation, as they are likelier to engage in suicide attempts. Patients with factors associated with increasing or persistent suicidal ideation trajectories should be targeted for suicide prevention interventions from the early phase of follow-up. Given the small number of persons in these trajectories and the wide CIs for some factors, larger studies are however needed to further characterize who belongs in each group.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"850-859"},"PeriodicalIF":4.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9323420","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":"Changes in mortality for the general population and individuals with pre-pandemic acute care for alcohol or opioids during the COVID-19 pandemic in Ontario, Canada.","authors":"Daniel Thomas Myran,&nbsp;Erik Loewen Friesen,&nbsp;Michael Pugliese,&nbsp;Christina Milani,&nbsp;Peter Tanuseputro","doi":"10.1177/07067437231156000","DOIUrl":"10.1177/07067437231156000","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"876-879"},"PeriodicalIF":4.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931873/pdf/10.1177_07067437231156000.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10726030","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":"Mental Health and the Climate Crisis: A Call to Action for Canadian Psychiatrists.","authors":"Daniel Rosenbaum, Sarah Levitt","doi":"10.1177/07067437231175532","DOIUrl":"10.1177/07067437231175532","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"870-875"},"PeriodicalIF":4.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929542","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 a Publicly-Funded Pharmacare Program on Prescription Stimulant use Among Children and Youth: A Population-Based Observational Natural Experiment.","authors":"Tony Antoniou,&nbsp;Daniel McCormack,&nbsp;Sophie Kitchen,&nbsp;Kathleen Pajer,&nbsp;William Gardner,&nbsp;Yona Lunsky,&nbsp;Melanie Penner,&nbsp;Mina Tadrous,&nbsp;Muhammad Mamdani,&nbsp;David N Juurlink,&nbsp;Tara Gomes","doi":"10.1177/07067437231166836","DOIUrl":"10.1177/07067437231166836","url":null,"abstract":"<p><strong>Objective: </strong>Stimulants are first-line pharmacotherapy for individuals with attention-deficit hyperactivity disorder. However, disparities in drug coverage may contribute to inequitable treatment access. In January 2018, the government of Ontario, Canada, implemented a publicly-funded program (OHIP+) providing universal access to medications at no cost to children and youth between the ages of 0 and 24. In April 2019, the program was amended to cover only children and youth without private insurance. We studied whether these policy changes were associated with changes in prescription stimulant dispensing to Ontario children and youth.</p><p><strong>Methods: </strong>We conducted a population-based observational natural experiment study of stimulant dispensing to children and youth in Ontario between January 2013 and March 2020. We used interventional autoregressive integrated moving average models to estimate the association between OHIP+ and its subsequent modification with stimulant dispensing trends.</p><p><strong>Results: </strong>The implementation of OHIP+ was associated with a significant immediate increase in the monthly rate of stimulant dispensing of 53.6 individuals per 100,000 population (95% confidence interval [CI], 36.8 to 70.5 per 100,000) and a 14.2% (95% CI, 12.8% to 15.6%) relative percent increase in stimulant dispensing rates between December 2017 and March 2019 (1198.6 vs. 1368.7 per 100,000 population). The April 2019 OHIP+ program amendment was associated with an increase in monthly stimulant dispensing trends of 10.2 individuals per 100,000 population (95% CI, 5.0 to 15.5), with rates increasing 7.5% (95% CI, 6.2% to 8.7%) between March 2019 and March 2020 (1368.7 vs. 1470.8 per 100,000 population). These associations were most pronounced among males, children and youth living in the highest income neighbourhoods and individuals aged 20 to 24.</p><p><strong>Conclusion: </strong>A publicly-funded pharmacare program was associated with more children and youth being dispensed stimulants.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"826-837"},"PeriodicalIF":4.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/a4/10.1177_07067437231166836.PMC10590092.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456498","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":"Do Anxiety Symptoms Mediate the Association Between Cannabis Use Frequency and Psychotic-Like Experiences in Emerging Adult Undergraduates?","authors":"Haley C R Bernusky,&nbsp;Philip G Tibbo,&nbsp;Patricia J Conrod,&nbsp;Fakir Md Yunus,&nbsp;Matthew T Keough,&nbsp;Kara D Thompson,&nbsp;Marvin D Krank,&nbsp;Allyson F Hadwin,&nbsp;Sherry H Stewart","doi":"10.1177/07067437231176900","DOIUrl":"10.1177/07067437231176900","url":null,"abstract":"<p><strong>Objective: </strong>Cannabis is commonly used by Canadian emerging adults (ages 18-25 years), many of whom attend post-secondary institutions. Frequent cannabis use is linked with psychotic-like experiences (PLEs); however, the exact nature of this association remains unclear. Anxiety symptoms may mediate this association, as they are prevalent in emerging adults and have been independently linked with both cannabis use and PLEs. Past work found that anxiety mediated the association between cannabis use frequency and attenuated positive psychotic symptoms (further along the psychosis continuum than PLEs), however this research had yet to be validated in the Canadian population, and trait rather than state anxiety (frequency of anxiety symptoms) was studied. Thus, our primary objective was to examine if anxiety symptoms mediated the association between cannabis use frequency and PLEs in Canadian emerging adult undergraduates. Despite known sex differences in cannabis use, expression of anxiety, and PLEs, past work did not evaluate the potential impact of biological sex on the anxiety-mediated model, and thus is the secondary objective of the present study.</p><p><strong>Methods: </strong>1,266 first-/second-year emerging adult undergraduates from five Canadian universities provided cross-sectional, self-report survey data in fall 2021 semester. Validated measures of cannabis use frequency, anxiety, and PLEs were administered.</p><p><strong>Results: </strong>Path analyses supported mediation from cannabis use to PLEs through anxiety (<i>b</i>  =  0.07, <i>P</i> < 0.001, 95% bootstrap CI [0.03, 0.10]). No direct effect was found (<i>P</i>  =  0.457), suggesting that the cannabis-to-PLEs association was mediated by anxiety. Mediation did not depend on biological sex (i.e., bootstrapped 95% CIs crossed zero).</p><p><strong>Conclusions: </strong>Anxiety symptoms mediated the association between cannabis use and PLEs in emerging adults regardless of their biological sex. Assuming replication in prospective research, results highlight anxiety as an important intervention target in frequent cannabis-using emerging adults, to potentially prevent development/worsening of PLEs, and in turn psychotic illness.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"860-869"},"PeriodicalIF":4.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9476964","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":"Amphetamine-Related Emergency Department Visits in Ontario, Canada, 2003-2020.","authors":"James A G Crispo,&nbsp;Lisa Liu,&nbsp;Paxton Bach,&nbsp;Dominique R Ansell,&nbsp;Branavan Sivapathasundaram,&nbsp;Francis Nguyen,&nbsp;Paul Kurdyak,&nbsp;Dallas P Seitz,&nbsp;Michael Conlon,&nbsp;Jacquelyn J Cragg","doi":"10.1177/07067437231158933","DOIUrl":"10.1177/07067437231158933","url":null,"abstract":"<p><strong>Objectives: </strong>Despite unregulated amphetamine use increasing, there are limited data on related emergency department (ED) visits in Canada. Our primary objective was to examine trends in amphetamine-related ED visits over time in Ontario, including by age and sex. Secondary objectives were to examine whether patient characteristics were associated with ED revisit within 6 months.</p><p><strong>Methods: </strong>Using administrative claims and census data, we calculated annual patient- and encounter-based rates of amphetamine-related ED visits from 2003 to 2020 among individuals 18+ years of age. We also performed a retrospective cohort study of individuals with amphetamine-related ED visits between 2019 and 2020 to determine whether select factors were associated with ED revisit within 6 months. Multivariable logistic regression modelling was used to measure associations.</p><p><strong>Results: </strong>The population-based rate of amphetamine-related ED visits increased nearly 15-fold between 2003 (1.9/100,000 Ontarians) and 2020 (27.9/100,000 Ontarians). Seventy-five percent of individuals returned to the ED for any reason within 6 months. Psychosis and use of other substances were both independently associated with ED revisit for any reason within 6 months (psychosis: AOR = 1.54, 95% CI = 1.30-1.83; other substances: AOR = 1.84, 95% CI = 1.57-2.15), whereas having a primary care physician was negatively associated with ED revisit (AOR = 0.77, 95% CI = 0.60-0.98).</p><p><strong>Conclusions: </strong>Increasing rates of amphetamine-related ED visits in Ontario are cause for concern. Diagnoses of psychosis and the use of other substances may serve to identify individuals who are most likely to benefit from both primary and substance-specific care.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"838-849"},"PeriodicalIF":4.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/33/10.1177_07067437231158933.PMC10590093.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9430022","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":"Benefits of the PRISM Shelter-Based Program for Attainment of Stable Housing and Functional Outcomes by People Experiencing Homelessness and Mental Illness: A Quantitative Analysis.","authors":"Ghassen Soufi,&nbsp;Brigitte Voisard,&nbsp;Eric A Latimer,&nbsp;Lavina Matai,&nbsp;Erica E M Moodie,&nbsp;Vincent Laliberté","doi":"10.1177/07067437231162494","DOIUrl":"10.1177/07067437231162494","url":null,"abstract":"<p><strong>Objective: </strong>To explore the housing trajectory, personal recovery, functional level, and quality of life of clients at discharge and 1 year after completing <i>Projet Réaffiliation Itinérance Santé Mentale</i> (PRISM), a shelter-based mental health and rehabilitation program intended to provide individuals experiencing homelessness and severe mental illness with transition housing and to reconnect them with mental health and social services.</p><p><strong>Method: </strong>Housing status, psychiatric follow-up trajectory, personal recovery (Canadian Personal Recovery Outcome Measure), functional level (Multnomah Community Ability Scale), and quality of life (Lehman Quality of Life Interview) were assessed at program entry, at program discharge and 1 year later.</p><p><strong>Results: </strong>Of the 50 clients who participated in the study from May 31, 2018, to December 31, 2019, 43 completed the program. Of these, 76.7% were discharged to housing modalities and 78% were engaged with psychiatric follow-up at the program's end. Housing stability, defined as residing at the same permanent address since discharge, was achieved for 62.5% of participants at 1-year follow-up. Functional level and quality of life scores improved significantly both at discharge and at 1-year follow-up from baseline.</p><p><strong>Conclusions: </strong>Admission to PRISM helped clients secure long-term stable housing and appropriate psychiatric follow-up. Stable housing was maintained for most clients at 1-year follow-up, and they benefited from sustained functional and quality of life outcomes in long-term follow-up.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"745-754"},"PeriodicalIF":4.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10517648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9133442","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":"Incidence, Racial Disparities and Factors Related to Psychosis among Black Individuals in Canada: A Scoping Review.","authors":"Jude Mary Cénat,&nbsp;Élisabeth Dromer,&nbsp;Wina Paul Darius,&nbsp;Rose Darly Dalexis,&nbsp;Sarah Elizabeth Furyk,&nbsp;Hannah Poisson,&nbsp;Farid Mansoub Bekarkhanech,&nbsp;David Guangyu Diao,&nbsp;Andi Phaelle Gedeon,&nbsp;Muhammad S Shah,&nbsp;Patrick R Labelle,&nbsp;Emmanuelle Bernheim,&nbsp;Cary S Kogan","doi":"10.1177/07067437231178957","DOIUrl":"10.1177/07067437231178957","url":null,"abstract":"<p><strong>Objective: </strong>Black communities are increasingly concerned about psychosis, a worry echoed by provincial health-care systems across Canada. Responding to the lack of evidence on psychosis in Black communities, this scoping review examined the incidence and prevalence of psychosis, access to care (pathways to care, coercive referrals, interventions, etc.), treatments received, and stigma faced by individuals with psychosis.</p><p><strong>Method: </strong>To identify studies, a comprehensive search strategy was developed and executed in December 2021 across 10 databases, including APA PsycInfo, CINAHL, MEDLINE and Web of Science. Subject headings and keywords relating to Black communities, psychosis, health inequalities, Canada and its provinces and territories were used and combined. The scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping review (PRISMA-ScR) reporting standard.</p><p><strong>Results: </strong>A total of 15 studies met the inclusion criteria, all of them conducted in Ontario and Quebec. Results highlight different disparities in psychosis among Black communities. Compared to other Canadian ethnic groups, Black individuals are more likely to be diagnosed with psychosis. Black individuals with psychosis are more likely to have their first contact with health-care settings through emergency departments, to be referred by police and ambulance services, and to experience coercive referrals and interventions, and involuntary admission. Black individuals experience a lower quality of care and are the ethnic group most likely to disengage from treatment.</p><p><strong>Conclusion: </strong>This scoping review reveals many gaps in research, prevention, promotion and intervention on psychosis in Black individuals in Canada. Future studies should explore factors related to age, gender, social and economic factors, interpersonal, institutional and systemic racism, and psychosis-related stigma. Efforts should be directed toward developing trainings for health-care professionals and promotion and prevention programs within Black communities. Culturally adapted interventions, racially disaggregated data, and increased research funding are needed.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"713-731"},"PeriodicalIF":4.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/4d/10.1177_07067437231178957.PMC10517652.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9563359","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}