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

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Extending the Impact of Mood Disorder Care Through Treatment Optimization and Accessibility. 通过治疗优化和可及性来扩大情绪障碍护理的影响。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-10-01 Epub Date: 2025-09-18 DOI: 10.1177/07067437251374563
Peter Giacobbe, Muhammad Ishrat Husain
{"title":"Extending the Impact of Mood Disorder Care Through Treatment Optimization and Accessibility.","authors":"Peter Giacobbe, Muhammad Ishrat Husain","doi":"10.1177/07067437251374563","DOIUrl":"10.1177/07067437251374563","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":"70 10","pages":"729-731"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic Seizure Therapy in Refractory Psychiatric Disorders: A Systematic Review and Meta-Analysis: La thérapie par convulsions magnétiques pour la prise en charge des troubles psychiatriques réfractaires : revue systématique et méta-analyse. 屈光性精神障碍的磁癫痫治疗:系统综述与荟萃分析。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-10-01 Epub Date: 2024-12-09 DOI: 10.1177/07067437241301005
Jake Prillo, Lorina Zapf, Caroline W Espinola, Zafiris J Daskalakis, Daniel M Blumberger
{"title":"Magnetic Seizure Therapy in Refractory Psychiatric Disorders: A Systematic Review and Meta-Analysis: La thérapie par convulsions magnétiques pour la prise en charge des troubles psychiatriques réfractaires : revue systématique et méta-analyse.","authors":"Jake Prillo, Lorina Zapf, Caroline W Espinola, Zafiris J Daskalakis, Daniel M Blumberger","doi":"10.1177/07067437241301005","DOIUrl":"10.1177/07067437241301005","url":null,"abstract":"<p><strong>Objective: </strong>To qualitatively and quantitatively synthesize the literature on the efficacy and safety of magnetic seizure therapy (MST) in psychiatric disorders.</p><p><strong>Methods: </strong>A literature search was conducted of the OVID Medline, OVID EMBASE, PsychINFO, CINAHL, Web of Science and Cochrane databases from inception to 14 January 2024, using subject headings and key words for \"magnetic seizure therapy.\" Randomized controlled trials (RCTs), post-hoc analyses of RCTs, open-label trials, or case series investigating MST in adults with a verified psychiatric diagnosis and reporting on two possible primary outcomes (1) psychiatric symptom reduction (as measured by validated rating scale) or (2) neurocognitive outcomes (as measured by standardized testing), were included. Abstracts, individual case reports, reviews and editorials were excluded. Extracted data included: (1) basic study details; (2) study design; (3) sample size; (4) baseline demographics; (5) outcome data (including secondary outcomes of suicidal ideation and adverse events); and (6) stimulation parameters. Cochrane's risk of bias tool was applied. A quantitative analysis was conducted for the depression studies, using Hedge's g effect sizes.</p><p><strong>Results: </strong>A total of 24 studies (n = 377) were eligible for inclusion. Seventeen studies in depression (including three RCTs), four studies in schizophrenia (including one RCT), one study in bipolar disorder, one study in obsessive-compulsive disorder and one study in borderline personality disorder were summarized. We found no significant difference in depressive symptom reduction between MST and electroconvulsive therapy (ECT) in randomized, controlled trials (g = 0.207 towards ECT, 95% confidence interval (CI) -0.132 to 0.545, <i>P</i> = 0.232). We found a significant reduction in depressive symptoms overall with MST in the pooled RCT and open-label analysis (g = 1.749, CI 1.219 to 2.279, <i>P</i> < 0.005). It is suggested that MST has modest cognitive side effects.</p><p><strong>Conclusions: </strong>Large-scale RCTs are necessary to confirm early signals of MST as an effective intervention in psychiatric disorders with a cognitive profile that is potentially more favourable than ECT.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"732-749"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Personalising Antidepressant Treatment for Unipolar Depression Combining Individual Choices, Risks and big Data: The PETRUSHKA Tool: Personnalisation du traitement antidépresseur de la dépression unipolaire associant choix individuels, risques et mégadonnées: l'outil PETRUSHKA. 结合个人选择、风险和大数据的单极抑郁症个性化抗抑郁治疗:PETRUSHKA工具:结合个人选择、风险和大数据的单极抑郁症个性化抗抑郁治疗:PETRUSHKA工具。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-10-01 Epub Date: 2025-03-13 DOI: 10.1177/07067437251322399
Edoardo G Ostinelli, Matt Jaquiery, Qiang Liu, Rania Elgarf, Nyla Haque, Jennifer Potts, Zhenpeng Li, Orestis Efthimiou, Sarah Markham, Roger Ede, Laurence Wainwright, Karen Barros Parron Fernandes, Bianca Barros Parron Fernandes, Paulo Victor Carpaneze Dalaqua, Anneka Tomlinson, Katharine A Smith, Caroline Zangani, Franco De Crescenzo, Marcos Liboni, Benoit H Mulsant, Andrea Cipriani
{"title":"Personalising Antidepressant Treatment for Unipolar Depression Combining Individual Choices, Risks and big Data: The PETRUSHKA Tool: Personnalisation du traitement antidépresseur de la dépression unipolaire associant choix individuels, risques et mégadonnées: l'outil PETRUSHKA.","authors":"Edoardo G Ostinelli, Matt Jaquiery, Qiang Liu, Rania Elgarf, Nyla Haque, Jennifer Potts, Zhenpeng Li, Orestis Efthimiou, Sarah Markham, Roger Ede, Laurence Wainwright, Karen Barros Parron Fernandes, Bianca Barros Parron Fernandes, Paulo Victor Carpaneze Dalaqua, Anneka Tomlinson, Katharine A Smith, Caroline Zangani, Franco De Crescenzo, Marcos Liboni, Benoit H Mulsant, Andrea Cipriani","doi":"10.1177/07067437251322399","DOIUrl":"10.1177/07067437251322399","url":null,"abstract":"<p><strong>Objective: </strong>We summarize the key steps to develop and assess an innovative online, evidence-based tool that supports shared decision-making in routine care to personalize antidepressant treatment in adults with depression. This PETRUSHKA tool is part of the PETRUSHKA trial (Personalize antidEpressant Treatment foR Unipolar depreSsion combining individual cHoices, risKs, and big datA).</p><p><strong>Methods: </strong>The PETRUSHKA tool: (a) is based on prediction models, which use a combination of advanced analytics, i.e., traditional statistics, and machine learning methods; (b) utilizes electronic health records from primary care patients with depressive disorder in England and data from randomized controlled trials on antidepressants in depression, both at aggregate and individual patient level; (c) incorporates preferences from patients and clinicians (especially about adverse events); (d) generates a ranked list of personalized treatment recommendations to inform the discussion between clinicians and patients, and facilitates the final treatment choice. The PETRUSHKA tool is implemented as a web-based application, accessible from any computer, smartphone or tablet.</p><p><strong>Results: </strong>We employed a bespoke algorithm to identify the best antidepressant for each individual patient, using patients' clinical and demographic characteristics and harnessing the power of innovations in digital technology, large datasets and machine learning. We established a dedicated group of patient representatives that were involved in the co-production of the tool, to maximize its impact in real-world clinical practice across the world. To test the tool, we designed an international multi-site, randomized trial (target sample: 504 participants), comparing the PETRUSHKA tool with usual care to personalize pharmacological treatment in patients with depressive disorder across Brazil, Canada and the UK.</p><p><strong>Conclusions: </strong>Using evidence-based patient decision aids has been recommended to support shared decision-making when quality is assured. Future studies in precision mental health should develop multimodal web tools, incorporating patients' preferences and their individual demographic, cultural, clinical, and genetic characteristics.Plain Language Summary TitleTailoring antidepressant treatment to individual patients with depression: the PETRUSHKA tool.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"768-781"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Comorbid Posttraumatic Stress-Related Symptoms on Repetitive Transcranial Magnetic Stimulation for Depression in Civilians: Incidence des symptômes du trouble de stress post-traumatique (TSPT) comorbide sur la stimulation magnétique transcrânienne répétitive pour traiter la dépression. 共病创伤后应激相关症状对平民抑郁症的反复经颅磁刺激的影响:共病创伤后应激障碍(TSPT)症状对反复经颅磁刺激治疗抑郁症的影响。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-10-01 Epub Date: 2025-05-30 DOI: 10.1177/07067437251342277
Enoch Ng, Sean M Nestor, Jennifer S Rabin, Clement Hamani, Nir Lipsman, Peter Giacobbe
{"title":"Impact of Comorbid Posttraumatic Stress-Related Symptoms on Repetitive Transcranial Magnetic Stimulation for Depression in Civilians: Incidence des symptômes du trouble de stress post-traumatique (TSPT) comorbide sur la stimulation magnétique transcrânienne répétitive pour traiter la dépression.","authors":"Enoch Ng, Sean M Nestor, Jennifer S Rabin, Clement Hamani, Nir Lipsman, Peter Giacobbe","doi":"10.1177/07067437251342277","DOIUrl":"10.1177/07067437251342277","url":null,"abstract":"<p><strong>Objectives: </strong>The impact of comorbid posttraumatic stress disorder (PTSD) symptoms on the anti-depressive outcomes of repetitive transcranial magnetic stimulation (rTMS) for civilians with major depressive disorder (MDD) is poorly studied. We aimed to understand whether proximal PTSD symptoms would interact with distal traumas in impacting depression outcomes from rTMS treatment.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 133 patients with MDD receiving open-label high-frequency rTMS to the left dorsolateral prefrontal cortex for 4 weeks. Probable PTSD was defined as scoring ≥ 4 on the Primary Care PTSD Screen for DSM-5. Distal traumas were quantified using the Adverse Childhood Experiences (ACE-10) questionnaire. Primary outcomes were improvement in Hamilton Rating Scale for Depression 17 item scale (HAMD-17) scores from baseline to 4 weeks as well as remission (HAMD-17 ≤ 7) and response (greater than 50% improvement from baseline).</p><p><strong>Results: </strong>29/133 had probable PTSD. Patients with probable PTSD had more ACEs, as well as higher depression, anxiety and medical comorbidity scores. Neither probable PTSD status nor its interaction with ACEs significantly impacted depression outcomes. However, having more ACEs was associated with greater odds of remission and response.</p><p><strong>Conclusions: </strong>Our findings suggest neither co-morbid PTSD symptoms nor distal childhood adversities should preclude patients with MDD from receiving rTMS for depression.Plain Language Summary TitleRepetitive transcranial magnetic stimulation for civilian patients with depression and posttraumatic stress symptoms.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"796-805"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Procognitive Effects of Adjunctive D-Cycloserine to Intermittent Theta-Burst Stimulation in Major Depressive Disorder: Effets procognitifs de la D-cyclosérine en traitement complémentaire par la stimulation thêta-burst intermittente dans le trouble dépressif caractérisé. 间歇性θ-猝发刺激辅助D-环丝氨酸对重度抑郁障碍的前认知效应
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-10-01 Epub Date: 2024-10-29 DOI: 10.1177/07067437241293984
Marilena M DeMayo, Jaeden Cole, Myren N Sohn, Signe L Bray, Ashley D Harris, Scott B Patten, Alexander McGirr
{"title":"Procognitive Effects of Adjunctive D-Cycloserine to Intermittent Theta-Burst Stimulation in Major Depressive Disorder: Effets procognitifs de la D-cyclosérine en traitement complémentaire par la stimulation thêta-burst intermittente dans le trouble dépressif caractérisé.","authors":"Marilena M DeMayo, Jaeden Cole, Myren N Sohn, Signe L Bray, Ashley D Harris, Scott B Patten, Alexander McGirr","doi":"10.1177/07067437241293984","DOIUrl":"10.1177/07067437241293984","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder (MDD) is associated with cognitive impairments that persist despite successful treatment. Transcranial magnetic stimulation is a noninvasive treatment for MDD that is associated with small procognitive effects on working memory and executive function. We hypothesized that pairing stimulation with N-methyl-D-aspartate (NMDA) receptor agonism would enhance the effects of stimulation and its procognitive effects.</p><p><strong>Method: </strong>The effect of NMDA receptor agonism (D-cycloserine, 100 mg) on cognitive performance was tested in two randomized double-blind placebo-controlled trials: (1) acute effects of in the absence of stimulation (<i>n </i>= 20 healthy participants) and (2) a treatment study of individuals with MDD (<i>n </i>= 50) randomized to daily intermittent theta-burst stimulation (iTBS) with placebo or D-cycloserine for 2 weeks. Cognitive function was measured using the THINC-it battery, comprised of the Perceived Deficits Questionnaire, the Choice Reaction Time, the Trail Making Test, the Digit Symbol Substitution Test, and the 1-Back tests.</p><p><strong>Results: </strong>D-cycloserine had no acute effect on cognition compared to placebo. iTBS + D-cycloserine was associated with significant improvements in subjective cognitive function and correct responses on the 1-Back when compared to iTBS + placebo. Improvements in subjective cognition paralleled depressive symptoms improvement, however 1-Back improvements were not attributable to improvement in depression.</p><p><strong>Conclusions: </strong>An intersectional strategy pairing iTBS with NMDA receptor agonism may restore cognitive function in MDD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"750-758"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Survey Exploring People's Experiences With Lithium Bought as a Supplement: Une enquête sur l'expérience des personnes avec le lithium en supplément. 一项调查探索人们购买锂补充剂的经历:一项关于人们购买锂补充剂的经历的调查。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-10-01 Epub Date: 2025-03-28 DOI: 10.1177/07067437251328282
Rebecca Strawbridge, Samuel Myrtle, Pietro Carmellini, Elliot Hampsey, David A Cousins, Allan H Young
{"title":"A Survey Exploring People's Experiences With Lithium Bought as a Supplement: Une enquête sur l'expérience des personnes avec le lithium en supplément.","authors":"Rebecca Strawbridge, Samuel Myrtle, Pietro Carmellini, Elliot Hampsey, David A Cousins, Allan H Young","doi":"10.1177/07067437251328282","DOIUrl":"10.1177/07067437251328282","url":null,"abstract":"<p><strong>Objective: </strong>Lithium, despite its evidence base and range of indications, is often underutilized due to safety concerns associated with high-dose prescriptions and consequent necessity for regular blood monitoring. Emerging evidence suggests its potential benefits at lower doses, especially for its pro-cognitive effects and positive safety profile. While accessible as a supplement, empirical human evidence on neuropsychiatric effects is lacking. This study aimed to provide preliminary evidence regarding the utilization and perceived effects of low-dose lithium supplements (LiS) in the community.</p><p><strong>Methods: </strong>Cross-sectional, opportunistic survey of 211 participants aged ≥18 years who disclosed taking over-the-counter lithium supplements. The survey assessed sample demographics, supplement details, overall perspectives, and personal experiences related to the use of LiS.</p><p><strong>Results: </strong>The most common form of LiS taken was aspartate at 10 mg once per day, although lithium orotate and ionic lithium were also frequently used. The most common beliefs regarding the benefits of using lithium as a supplement concern efficacy for anxiety, but the most common improvements experienced was in the domain of cognition, closely followed by anxiety and mood. Mood was most commonly reported as the greatest improvement. Side effects and withdrawal phenomena were more prevalent than anticipated.</p><p><strong>Conclusion: </strong>This study revealed a diverse range of lithium supplements taken, in terms of dosage, formulation, frequency, and duration of intake. Anecdotal evidence highlighted prevalent perceived benefits and adverse effects. The study is, however, limited notably by its cross-sectional opportunistic design; more robust evidence, especially from controlled trials, is needed to fully establish the specific benefits and drawbacks associated with different forms and doses of accessible lithium supplements.Plain Language Summary TitleA survey exploring people's experiences with lithium bought as a supplement.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"782-795"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Principles Underlying Mental Health Legislation. 精神健康立法的基本原则。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-09-30 DOI: 10.1177/10556656251339898
Richard L O'Reilly, Grainne Neilson, Mathieu Dufour, Gary Chaimowitz
{"title":"Principles Underlying Mental Health Legislation.","authors":"Richard L O'Reilly, Grainne Neilson, Mathieu Dufour, Gary Chaimowitz","doi":"10.1177/10556656251339898","DOIUrl":"10.1177/10556656251339898","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"10556656251339898"},"PeriodicalIF":3.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-Stay Psychiatric Inpatients With and Without Intellectual and Developmental Disabilities: An Ontario Population-Based Study: Patients hospitalisés pour de longs séjours en psychiatrie avec ou sans déficiences intellectuelles et développementales,: Une étude fondée sur la population de l'Ontario. 有或没有智力和发育障碍的长期住院精神病人:一项以安大略省人口为基础的研究:有或没有智力和发育障碍的长期住院精神病人。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-09-29 DOI: 10.1177/07067437251380731
Avra Selick, Michael A Campitelli, Anjie Huang, Robert Balogh, Paul Kurdyak, Yona Lunsky
{"title":"Long-Stay Psychiatric Inpatients With and Without Intellectual and Developmental Disabilities: An Ontario Population-Based Study: Patients hospitalisés pour de longs séjours en psychiatrie avec ou sans déficiences intellectuelles et développementales,: Une étude fondée sur la population de l'Ontario.","authors":"Avra Selick, Michael A Campitelli, Anjie Huang, Robert Balogh, Paul Kurdyak, Yona Lunsky","doi":"10.1177/07067437251380731","DOIUrl":"10.1177/07067437251380731","url":null,"abstract":"<p><p>ObjectivePatients with intellectual and developmental disabilities (IDDs) and psychiatric disorders are at higher risk for prolonged hospitalisations. The aim of this study was to examine the prevalence of IDD among long-stay inpatients in Ontario psychiatric beds, and compare the demographic and clinical profiles of long-stay inpatients with and without IDD.MethodsThis Ontario population-based cross-sectional study used linked health administrative databases. All patients over 18 years of age occupying a non-forensic psychiatric inpatient bed in Ontario on September 30th, 2023 were included in the analysis. We examined prevalence of IDD among patients with a length of stay (LOS) ≥ 365 days ('long-stay patients'). Standardised differences were used to compare demographic, clinical, functional, and health care utilisation characteristics between patients with and without IDD.ResultsOf the 1,466 long-stay patients in an Ontario non-forensic psychiatric inpatient bed, 22.0% had IDD. They were younger (mean age 44.3 vs. 47.6) and a higher proportion were male (64.3% vs. 50.1%). In the 2 years prior to admission, a higher proportion of long-stay patients with IDD had a psychotic disorder (73.3% vs. 54.0%), and they had a higher median number of ED visits (5 vs. 3). Long-stay inpatients with IDD were more likely to have difficulty with activities of daily living (39.8% vs. 15.0%), moderate/severe cognitive impairment (63.0% vs. 29.9%) and fewer social contacts in place to support discharge (59.3% vs. 48.6%). While in hospital, a greater proportion of long-stay patients with IDD were subject to restraints (12.4% vs. 8.0%) and seclusion (20.2% vs. 11.2%).ConclusionsAdults with IDD account for more than one in five long-stay psychiatric inpatients and have unique needs including greater cognitive impairment and difficulty caring for themselves. Successful transitions out of hospital require specialised resources and cross-sectoral collaboration.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251380731"},"PeriodicalIF":3.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outpatient Care Before and After Mental Health Hospitalization for Adolescents From Immigrant, Refugee and Non-immigrant Backgrounds in British Columbia: A Retrospective Cohort Study: Soins en consultation externe avant et après une hospitalisation en santé mentale pour les adolescents, issus ou non de l'immigration ou réfugiés, en Colombie-Britannique: Une étude de cohorte rétrospective. Outpatient Care先寄存Mental Health Hospitalization for青少年从移民、难民和非Backgrounds in British Columbia)回顾了队列研究:前后护理门诊住院产生的青少年心理健康与否有移民或难民,在不列颠哥伦比亚:回顾性队列研究。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-09-26 DOI: 10.1177/07067437251372189
Anne Gadermann, Monique Gagné Petteni, Carly Magee, Magdalena Janus, Katholiki Georgiades, Roberto Sassi, Martin Guhn, Joseph H Puyat
{"title":"Outpatient Care Before and After Mental Health Hospitalization for Adolescents From Immigrant, Refugee and Non-immigrant Backgrounds in British Columbia: A Retrospective Cohort Study: Soins en consultation externe avant et après une hospitalisation en santé mentale pour les adolescents, issus ou non de l'immigration ou réfugiés, en Colombie-Britannique: Une étude de cohorte rétrospective.","authors":"Anne Gadermann, Monique Gagné Petteni, Carly Magee, Magdalena Janus, Katholiki Georgiades, Roberto Sassi, Martin Guhn, Joseph H Puyat","doi":"10.1177/07067437251372189","DOIUrl":"10.1177/07067437251372189","url":null,"abstract":"<p><p>ObjectiveUnderstanding differences in outpatient care before and after mental health hospitalization for adolescents from diverse backgrounds is critical to ensuring effective and responsive care. The objective of the current study was to examine outpatient mental health care in the two years before and 30 days after a mental health hospitalization for adolescents from immigrant, refugee and non-immigrant backgrounds.MethodThis retrospective, population-based cohort study, conducted in British Columbia (BC), Canada, analyzed linked health service utilization data (practitioner billings, hospitalizations) and migration records to track outpatient care before and after mental health hospitalization. The study included adolescents (ages 10-18) with an unscheduled/urgent mental health hospitalization between January 1, 2008 and December 31, 2016 (n = 5,314) from a cohort of adolescents in 10 of the largest school districts in BC (between 1996 and 2016). The main analyses examined outpatient mental health visits (e.g., general practitioner/psychiatrist) (i) in the two years before hospitalization and (ii) in the 30 days after discharge. Sub-analyses focused on outpatient visits with psychiatrists.ResultsOverall, 30.4% had no outpatient mental health visit in the two years before hospitalization and 45.1% had none in the 30 days following discharge. First-generation immigrants and refugees and second-generation immigrant adolescents were significantly less likely than non-immigrants to have had an outpatient mental health visit in the two years before mental health hospitalization (aOR<sub>1st_gen_immg</sub> = 0.79, 95% CI, 0.63 to 0.98; aOR<sub>2nd_gen_immg</sub> = 0.75, 95% CI, 0.61 to 0.93; aOR<sub>1st_gen_ref</sub> = 0.40, 95% CI, 0.26 to 0.64). Second-generation immigrant adolescents were significantly more likely than non-immigrants to have had any outpatient mental health visit in the 30 days following hospitalization (aOR<sub>2nd_gen_immg</sub> = 1.34, 95% CI, 1.09 to 1.65).ConclusionsResults suggest outpatient care before and after mental health hospitalizations is limited for many adolescents in BC and differed by migration background. Implications for meeting standards of care are discussed.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251372189"},"PeriodicalIF":3.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180420","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}
引用次数: 0
Anticonvulsant Use in Older Age Bipolar Disorder in a Global Sample from the Global Aging and Geriatric Experiments in Bipolar Disorder Project: Utilisation d'anticonvulsivants pour le traitement des troubles bipolaires du sujet âgé auprès d'un échantillon mondial provenant du projet GAGE-BD. 抗惊厥药物在老年双相情感障碍中的应用:在来自GAGE-BD项目的全球样本中使用抗惊厥药物治疗老年双相情感障碍。
IF 3.8 3区 医学
Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2025-09-22 DOI: 10.1177/07067437251372190
Katie C Bodenstein, Myriam Lesage, Paola Lavin, Sigfried Schouws, Melis Orhan, Alexandra Beunders, Osvaldo P Almeida, Kursat Altinbas, Vicent Balanzá-Martínez, Izabela G Barbosa, Hilary P Blumberg, Farren B S Briggs, Cynthia V Calkin, Orestes V Forlenza, Brent Forester, Ariel G Gildengers, Benno C M Haarman, Tomas Hajek, Beny Lafer, Paula Nune, Benoit Mulsant, Andrew T Olagunju, Regan E Patrick, Joquim Radua, Kaylee Sarna, Christian Simhandl, Jair C Soares, Ashley N Sutherland, Nicole Fiorelli, Antonio L Teixeira, Shangying Tsai, Eduard Vieta, Joy Yala, Lisa Eyler, Annemiek Dols, Martha Sajatovic, Soham Rej
{"title":"Anticonvulsant Use in Older Age Bipolar Disorder in a Global Sample from the Global Aging and Geriatric Experiments in Bipolar Disorder Project: Utilisation d'anticonvulsivants pour le traitement des troubles bipolaires du sujet âgé auprès d'un échantillon mondial provenant du projet GAGE-BD.","authors":"Katie C Bodenstein, Myriam Lesage, Paola Lavin, Sigfried Schouws, Melis Orhan, Alexandra Beunders, Osvaldo P Almeida, Kursat Altinbas, Vicent Balanzá-Martínez, Izabela G Barbosa, Hilary P Blumberg, Farren B S Briggs, Cynthia V Calkin, Orestes V Forlenza, Brent Forester, Ariel G Gildengers, Benno C M Haarman, Tomas Hajek, Beny Lafer, Paula Nune, Benoit Mulsant, Andrew T Olagunju, Regan E Patrick, Joquim Radua, Kaylee Sarna, Christian Simhandl, Jair C Soares, Ashley N Sutherland, Nicole Fiorelli, Antonio L Teixeira, Shangying Tsai, Eduard Vieta, Joy Yala, Lisa Eyler, Annemiek Dols, Martha Sajatovic, Soham Rej","doi":"10.1177/07067437251372190","DOIUrl":"10.1177/07067437251372190","url":null,"abstract":"<p><strong>Background: </strong>Anticonvulsants are an essential treatment for bipolar disorder; however, there is relatively little known about their use in older age bipolar disorder (OABD). In this paper, which leverages a large international dataset, we aim to 1) describe the use of anticonvulsants in OABD compared to younger age bipolar disorder (YABD; ages <50 years old) and 2) explore any demographic/clinical correlates.</p><p><strong>Methods: </strong>A secondary analysis was conducted on the international data from the Global Aging and Geriatric Experiments in Bipolar Disorder project. The main objective was to report the prevalence of anticonvulsant use in OABD over 50 years old (mean age = 62.27) and the most prescribed anticonvulsant. Additional analysis explored any demographic and clinical correlates associated with anticonvulsant use. Generalized linear mixed models were used for this analysis.</p><p><strong>Results: </strong>Of the 2,691 participants with bipolar disorder who had anticonvulsant prescribing data, 34.4% (n = 926) used anticonvulsants at the time of study. Rates of anticonvulsant prescribing did not significantly differ between OABD and YABD groups (36.7% (n = 666) vs. 29.7% (n = 260)). Anticonvulsant prescribing patterns for OABD and YABD did not significantly differ, with valproate as the most prescribed anticonvulsant. OABD anticonvulsant users had less lithium use, more antidepressant use, more rapid cycling, more mood episodes and more cardiovascular comorbidities compared to nonusers.</p><p><strong>Conclusion: </strong>Anticonvulsant use was similar in OABD and YABD. A number of important clinical correlates of anticonvulsant use were identified.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251372190"},"PeriodicalIF":3.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126614","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}
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