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

{"title":"Longitudinal Validity of the DUNDRUM-1 Triage Security Scale in a Canadian Not Criminally Responsible Cohort: A Retrospective Study of 85 Patients.","authors":"Alexandre Hudon, Fanie Chainey, Catherine Degré, Anne-Renée Courtemanche, Marc-André Meunier, Allyson Fortier, Camille Bourque, Loriane Boulé, Vincent Latreille, Sophie Mongeon, Jeanne-Marie Allard, Stéphanie Borduas Pagé","doi":"10.1177/07067437261497471","DOIUrl":"10.1177/07067437261497471","url":null,"abstract":"<p><p>ObjectiveTo evaluate the longitudinal stability of DUNDRUM-1 Triage Security Scale recommendations among individuals found not criminally responsible on account of mental disorder (NCRMD) receiving care within a Canadian forensic psychiatric service.MethodsWe conducted a retrospective cohort study of adults found NCRMD who received a DUNDRUM-1 assessment at a tertiary academic forensic psychiatric centre in Quebec between 1 January 2019 and 31 December 2024. Eligible participants were aged ≥18 years and had a minimum of 12 months of follow-up. Demographic, forensic, and clinical variables were extracted from electronic medical records. Primary outcomes included changes in level of therapeutic security within 12 months. Secondary outcomes included psychiatric rehospitalization and transitions across DUNDRUM security categories. Descriptive statistics, Fisher's exact tests, Mann-Whitney U tests, and exploratory logistic regression analyses were performed.ResultsEighty-five individuals met inclusion criteria. The cohort was predominantly male (91.8%) with a mean age of 39.0 years (SD = 11.9). Schizophrenia spectrum disorders were the most common primary diagnosis (83.5%), while substance-related disorders (74.1%) and personality disorders (49.4%) were frequent comorbidities. Initial DUNDRUM recommendations included low security (56.5%), medium security (35.3%), open settings (4.7%), and maximum security (3.5%). Overall, 72 participants (84.7%) remained within their initially recommended level of care over 12 months, while 13 (15.3%) required a change in therapeutic security. Psychiatric rehospitalization occurred in 12 participants (14.1%). Exploratory analyses identified the mean violence-related DUNDRUM score as the only significant predictor of changes in level of care (OR = 2.88, 95% CI: 1.03-8.00, <i>p</i> = .043). In exploratory random forest analysis, SHapley Additive exPlanations ranked the mean violence-related DUNDRUM-1 score as the most influential model feature.ConclusionsDUNDRUM-1 recommendations demonstrated substantial longitudinal stability within this Canadian NCRMD cohort, supporting the ecological validity of the instrument and highlighting the potential importance of violence-related domains in predicting medium-term forensic outcomes.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261497471"},"PeriodicalIF":4.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186245","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":"Healthcare Pattern of Use Before and After Initiating a Long-Acting Antipsychotic Among a Cohort of 6221 Patients With a History of Psychosis.","authors":"Emmanuel Stip, Josiane Courteau, Sébastien Brodeur, Yohann M Chiu, Marie-Josée Fleury, Alain Lesage, Marc-André Roy","doi":"10.1177/07067437261462697","DOIUrl":"10.1177/07067437261462697","url":null,"abstract":"<p><p>ObjectiveTo evaluate changes in antipsychotic treatment patterns and healthcare utilization before and after initiation of long-acting injectable antipsychotics (LAI-APs) in a large Québec population cohort, comparing individuals with schizophrenia (SCZ) to those with other psychotic disorders (non-SCZ).MethodWe conducted a retrospective cohort study using linked Québec administrative databases (RAMQ, MED-ECHO, and public drug insurance) to identify 6,221 adults who initiated a LAI-AP between April 2013 and December 2016, after a 12-month LAI-free period. Participants were followed for 12 months before and after the index date. The cohort was stratified into SCZ and non-SCZ, and were further divided by regimen at initiation (LAI only; LAI + clozapine; LAI + other oral antipsychotic). Antipsychotic exposure and health-service usage (hospitalizations, emergency visits, outpatient and community care) trajectories were analyzed weekly using state-sequence analysis; pre- versus post-initiation comparisons used paired statistical tests.ResultsOf 6,221 patients (63.4% male; mean age 41.6 years), initial treatments consisted of paliperidone LAI (55.7%), aripiprazole LAI (21.5%), risperidone LAI (6.9%), first-generation LAI (15.6%), and LAI combinations (0.2%); 40% received LAI only, 5% LAI + clozapine, 55% LAI + an oral antipsychotic. SCZ patients were more often male, economically disadvantaged, and more likely to receive clozapine. After LAI initiation, hospital days fell sharply by almost 70% and outpatient and community-care visits increased substantially. Use of oral antipsychotics decreased overall post-initiation, except for clozapine (which rose) and first-generation oral drugs (which remained stable).ConclusionsIn this real-world Québec cohort, LAI-AP initiation was followed by a marked reduction in hospitalizations and a shift toward outpatient and community care, regardless of diagnosis. Observed differences in sociodemographic and clinical profiles between SCZ and non-SCZ patients-and among SCZ treatment subgroups-suggest the need for tailored care pathways. These findings support LAI-AP effectiveness in reducing healthcare utilization and inform resource planning.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"792-805"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347400","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 Effect of Creatine Monohydrate on Mental Disorders: A Systematic Review of Randomized Controlled Trials: Effet du monohydrate de créatine sur les troubles mentaux : examen systématique des essais contrôlés à répartition aléatoire.","authors":"Bassam Jeryous Fares, Carl Zhou, Nicholas Fabiano, Stanley Wong, Brendon Stubbs, Risa Shorr, David Puder, Darren G Candow, Sergej M Ostojic, Marco Solmi","doi":"10.1177/07067437251408171","DOIUrl":"10.1177/07067437251408171","url":null,"abstract":"<p><p>ObjectiveThe objective of this systematic review is to synthesize and evaluate the evidence involving creatine monohydrate supplementation (CrM) across mental disorders.MethodsMEDLINE, Embase, Cochrane, and PsycINFO were searched up to 09/30/2025 for randomized controlled trials (RCTs) investigating the effect of CrM on psychiatric symptoms and safety in participants with a mental disorder. Risk of bias was assessed.ResultsSix articles from five RCTs were included (CrM: n = 126, placebo: n = 112; mean age=36 ± 14 years; male sex = 26%). Four RCTs reported on major depressive disorder (MDD), one bipolar depression. No other mental disorders were investigated. Two RCTs were low risk of bias and three had some concerns. CrM dosing ranged from 2 to 10 g/day for 4-8 weeks as adjunct treatment. In the treatment of MDD, CrM was tested as combination with escitalopram (k = 1, outperforming selective serotonin reuptake inhibitor (SSRI) + placebo; Cohen's d = 1.13 at 8 weeks), pharmacotherapy augmentation in adults (k = 1) and female adolescents (k = 1, no difference vs placebo), psychotherapy augmentation (k = 1, cognitive behavioural therapy (CBT) + CrM outperforming CBT + placebo) in MDD, and as pharmacotherapy augmentation in bipolar depression (k = 1, no difference vs placebo augmentation). Two trials in MDD found a correlation between CrM brain N-acetylaspartate and phosphocreatine, which was associated with larger improvement. CrM was generally well-tolerated. Two CrM out of 17 participants experienced hypomania/mania.ConclusionCrM shows promise as a combination treatment with SSRIs or for augmenting psychotherapy in MDD in adults. Double-blind, large-scale RCTs investigating the efficacy of CrM, with and without first-line therapies, are needed across mental disorders.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"741-751"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013415","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":"Acute Psychosis and the Risk of Motor Vehicle Crash: Psychose aiguë et risque d'accident de la route.","authors":"John A Staples, Daniel Daly-Grafstein, Mayesha Khan, Shannon Erdelyi, Herbert Chan, William G Honer, Jeffrey R Brubacher","doi":"10.1177/07067437261454782","DOIUrl":"10.1177/07067437261454782","url":null,"abstract":"<p><p>BackgroundLimited evidence guides fitness-to-drive decision-making following an episode of acute psychosis.MethodWe used population-based administrative health and driving data from British Columbia, Canada, to identify all police-attended motor vehicle crashes between 2000 and 2016. Drivers were considered exposed if a hospitalization for acute psychosis ended in the 6-week interval prior to the crash. We assessed the association between psychosis and crashes using a case-crossover design that controls for relatively fixed individual characteristics like personality and routine driving habits. We also conducted a responsibility analysis that accounted for changes in road exposure (kilometres of driving per month) that might occur soon after hospital discharge. Outcomes included involvement in a crash as a driver (for the case-crossover analysis) and driver responsibility for contributing to their crash (for the responsibility analysis). We used logistic regression to evaluate associations between these outcomes and recent hospitalization for acute psychosis, with adjustment for potential confounders.ResultsAmong 9,842 crashes in the case-crossover analysis, a hospital stay for acute psychosis ended in 199 pre-crash intervals and in 147 control intervals, suggesting acute psychosis was temporally associated with subsequent crash (2.0% vs. 1.5% of intervals; adjusted odds ratio (aOR), 1.32; 95% CI [1.05-1.66]; <i>P</i> = 0.02). Among 819,348 drivers with a police-attended crash and determinate crash responsibility, 178 of 235 drivers with a recent hospitalization for acute psychosis and 440,543 of 819,113 drivers without recent psychosis were deemed responsible for their crash (75.7% vs. 53.8%; aOR, 2.38; 95% CI [1.75-3.24]; <i>P</i> < 0.001).ConclusionsThe 6-week interval following a hospitalization for acute psychosis is associated with increased odds of crash and increased likelihood of driver responsibility for contributing to their crash. More stringent temporary driving restrictions after an episode of acute psychosis might reduce crash risk.Plain Language Summary TitleAre drivers at a higher risk of crash after recent hospitalization for acute psychosis?</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"780-791"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145618","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":"Revisiting the Exercise Recommendations in the 2023 CANMAT Guidelines for Major Depressive Disorder.","authors":"Madelaine Gierc, Yiling Tang, Victoria Whiteford, Daria Sosna, Yawei Wei, Guy Faulkner","doi":"10.1177/07067437261464744","DOIUrl":"10.1177/07067437261464744","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"755-758"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400044","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":"First-Year Impact of Drug Decriminalization on Mental- and Substance Use Disorder-Related Healthcare Encounters in British Columbia: An Interrupted Time Series Analysis.","authors":"Mana Mohebbian, Christian Schütz, Arminee Kazanjian, Rosemin Kassam, Joseph H Puyat","doi":"10.1177/07067437261416387","DOIUrl":"10.1177/07067437261416387","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"806-808"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12846885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068716","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":"Developmental Trajectories of Suicidality in Sexually Diverse and Heterosexual Adolescents: Findings From the Quebec Longitudinal Study of Child Development: Trajectoires développementales de suicidalité chez les adolescents hétérosexuels et de la diversité sexuelle : Résultats de l'Étude longitudinale sur le développement des enfants du Québec.","authors":"Sasha MacNeil, Roxanne Sicotte, Camille Davisse-Paturet, Elise Chartrand, Em Alexander, Myriam Lecousy, Alain Girard, Massimiliano Orri, Nicholas Chadi, Isabelle Ouellet-Morin, Annie Pullen Sansfaçon, Srividya N Iyer, Natalie Castellanos-Ryan, Ian Colman, Robert-Paul Juster, Marie-Claude Geoffroy","doi":"10.1177/07067437261442420","DOIUrl":"10.1177/07067437261442420","url":null,"abstract":"<p><p>IntroductionSexually diverse adolescents report higher suicidality (ideation and attempts) than their heterosexual peers, but information on the onset and course of suicidality from early adolescence to young adulthood among contemporary sexually diverse individuals remains limited. This study traces suicidality trajectories across this critical developmental period, comparing sexually diverse and heterosexual adolescents both overall and by sex assigned at birth.MethodsData was drawn from the Quebec Longitudinal Study of Child Development, an ongoing population-based prospective birth cohort. This study included 1,505 participants who self-reported their sexual attraction at ages 15-17 (2013-2015) and past-year suicidal ideation and attempts using 3-items at ages 13, 15, 17 and 23 (2011-2021) from which a suicidality severity score was derived.Results11.5% of the sample (n = 173, 60.5% female) reported sexually diverse attraction. Growth curve modelling tested the random effect of sexually diverse (vs. heterosexual) attraction on suicidality severity intercept, linear and quadratic latent growth factors. Age-specific contrasts in suicidality severity between sexually diverse and heterosexual adolescents were also examined. Compared to heterosexual adolescents, sexually diverse adolescents showed a steeper increase in suicidality severity from ages 13 to 17, and declining yet persisting disparities from ages 17 to 23. Although developmental trajectories differed across sexually diverse males and females, both experienced greater suicidality severity during adolescence compared with heterosexual peers.DiscussionOur findings point to a developmental trajectory in which sexually diverse adolescents, particularly females assigned at birth, experience elevated suicidality that persists into young adulthood. Targeted and timely interventions during this critical developmental period are essential for suicide prevention.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"759-769"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693774","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":"Psychiatric Care Systems Are Not Prepared for the Climate Crisis: A Call for Coordination and Evidence.","authors":"Sean A Kidd, Siqi Xue, Kwame McKenzie","doi":"10.1177/07067437261428945","DOIUrl":"10.1177/07067437261428945","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"752-754"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357606","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":"Prevalence of Comorbid Postpartum Depression and Anxiety in Birthing Parents Seeking Treatment for Postpartum Depression: Prévalence de la présence comorbide de la dépression et de l'anxiété post-partum chez les parents ayant accouché qui ont consulté en raison de la dépression post-partum.","authors":"Karley V George, Calan D Savoy, Haley Layton, Peter J Bieling, Ryan J Van Lieshout","doi":"10.1177/07067437261462698","DOIUrl":"10.1177/07067437261462698","url":null,"abstract":"<p><p>ObjectiveTo estimate the prevalence of comorbid postpartum depression (PPD) and postpartum anxiety (PPA) in birthing parents seeking treatment for PPD in Ontario, Canada and who were enrolled in 1 of 9 randomized controlled trials (RCTs) of cognitive behavioural therapies (CBT) for PPD.MethodsSecondary analysis of 9 pooled RCTs containing baseline data from 1920 birthing parents and conducted between 2017 and 2025. All participants were living in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) Scores ≥10 and infants <12 months old. Comorbid anxiety was assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale, the Penn State Worry Questionnaire (PSWQ) and/or the Mini International Neuropsychiatric Interview (MINI).ResultsSixty-six percent of participants with PPD (EPDS scores ≥10) had moderate to severe anxiety (GAD-7 scale score ≥10; 95% confidence interval (CI) 63-68%, 7 studies, <i>n</i> = 1654), and 69% with PPD met the cutoff for probable GAD (PSWQ scale score ≥61; 95% CI [63-74%], 2 studies, <i>n</i> = 254). Seventy percent of participants with MINI-defined current major depressive disorder (MDD) met <i>Diagnostic and Statistical Manual of Mental Disorders-4th Edition</i>-based criteria for any anxiety disorder (95% CI [64-76%], 6 studies, <i>n</i> <i>=</i> 448). Nearly 60% of participants with current MDD met criteria for GAD on the MINI (95% CI [52-61%], <i>n</i> = 448).ConclusionsMore than two-thirds of treatment-seeking individuals with PPD have clinically significant anxiety. Those with PPD, their families, and healthcare professionals should be aware of the high prevalence of anxiety in these individuals so that treatment plans can be optimized to best meet their needs.Trial RegistrationClinicalTrials.gov (https://clinicaltrials.gov/): NCT03039530, NCT03654261, NCT03285139, NCT04485000, NCT04928742, NCT04934488, NCT04913584, NCT05314361 and NCT05044455.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"770-779"},"PeriodicalIF":4.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364151","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":"Investigation of the Gut Microbiome in Treatment-Resistant Schizophrenia Compared to Healthy Controls: A Cross-Sectional Pilot Study: Étude du microbiome intestinal chez les patients atteints de schizophrénie résistante au traitement par rapport aux témoins sains : étude pilote transversale.","authors":"Jonathan C W Liu, Ilona Gorbovskaya, Amy Y Zhang, Margaret K Hahn, Giada De Palma, Daniel J Müller","doi":"10.1177/07067437261487782","DOIUrl":"10.1177/07067437261487782","url":null,"abstract":"<p><p>BackgroundSchizophrenia (SCZ) is a debilitating disorder affecting approximately 1% of the Canadian population and remains a major contributor to disease burden and disability. Up to one-third of individuals with SCZ are affected by treatment-resistant SCZ (TRS). Clozapine remains the most effective treatment for TRS. However, its use is limited by serious metabolic and immune-related side effects. The gut microbiome may be a potential contributor to both SCZ pathology and antipsychotic-induced side effects, though studies examining this in the clozapine-treated TRS population remain limited.MethodsThis cross-sectional case-control study compared the gut microbiome composition of 25 TRS patients receiving long-term clozapine treatment to 25 healthy controls (HCs) matched for age, sex, body mass index, and smoking status. Participants provided fecal samples and completed assessments of psychiatric symptoms, eating behaviors, dietary intake, and metabolic measures. Fecal microbiome composition and predicted function were assessed using 16S rRNA gene sequencing (v3 region).ResultsIndividuals with TRS being treated with clozapine presented with a distinct microbiome in comparison to HC, including reduced microbial diversity. Taxonomic analyses revealed reduced relative abundance of Firmicutes, while elevated relative abundance of <i>Eggerthella</i> spp., <i>Mucispirillum</i> spp., and unclassified species within the order SHA-98 (class Clostridia). Exploratory analyses also identified nominal associations between select microbial features and clinical measures, including Positive and Negative Syndrome Scale (PANSS) scores and gastrointestinal symptoms. Predicted functional pathway analysis suggested alterations in microbial metabolic potential consistent with a metabolically stressed, pro-inflammatory microbiome.ConclusionsIndividuals with clozapine-treated TRS demonstrate differences in gut microbiome composition compared to HC and are predicted to have some functional consequences relating to metabolic potential. These findings remain exploratory but contribute to a limited but growing body of literature in this clinically relevant population and provide a basis for longitudinal studies with appropriate comparator groups to better characterize these relationships and assess their clinical relevance.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261487782"},"PeriodicalIF":4.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992605","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}