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

{"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_{1st_gen_immg} = 0.79, 95% CI, 0.63 to 0.98; aOR_{2nd_gen_immg} = 0.75, 95% CI, 0.61 to 0.93; aOR_{1st_gen_ref} = 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_{2nd_gen_immg} = 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}

{"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}

{"title":"Psychiatric Training During Clerkship: Specific Recommendations for Reform-Part 1, Teaching and Learning.","authors":"Joseph Sadek, Carla Garcia, Nishardi Waidyaratne-Wijeratne, Khalid Bazaid, Alberto Choy, Kathryn C Fung, Rajat Jayas, Sreelatha Varapravan, Michael Sb Mak, Thomas Raedler, Hillary Bohler, Nina Kuzenko, Catherine Hickey, Harry Karlinsky, Marianne Côté-Olijnyk, Michael Harrington, Debra Hamer","doi":"10.1177/07067437241291774","DOIUrl":"10.1177/07067437241291774","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241291774"},"PeriodicalIF":3.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994672","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":"Innovations in the Treatment of Mood Disorders: Exploring Microbiome, Digital and Culturally Adapted Approaches.","authors":"Muhammad Ishrat Husain, Peter Giacobbe","doi":"10.1177/07067437251374600","DOIUrl":"10.1177/07067437251374600","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251374600"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979050","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":"Trajectories of Incarceration Over Six Years Among People with Mental Illness and Experiences of Homelessness: Predictive Factors Among Participants in a Randomized Trial of Housing First: Trajectoires d'incarcération sur six ans chez les personnes atteintes de maladie mentale et ayant connu l'itinérance-Facteurs prédictifs chez les participants à un essai à répartition aléatoire en marge du programme «Logement d'abord».","authors":"Linh D Luong, Cilia Mejia-Lancheros, Fiona Kouyoumdjian, James Lachaud, Stephen W Hwang","doi":"10.1177/07067437251372188","DOIUrl":"10.1177/07067437251372188","url":null,"abstract":"<p><p>ObjectiveTo identify long-term trajectories of incarceration, impact of Housing First intervention, and associated predictor factors among people with mental illness and experiences of homelessness who participated in a randomized trial of Housing First in Toronto, Canada.MethodsParticipants in the Toronto site of the At Home/Chez Soi study (<i>n</i> = 559) were followed from 2009 to 2017. The primary outcome of interest was incarceration trajectories, analyzed using group-based trajectory modelling. Multinomial logistic regression was used to examine the association between Housing First intervention, baseline socio-demographic and health characteristics, and trajectories of incarceration.ResultsThree group-based incarceration trajectories were identified: Low (66.3%), decreasing (23.1%), and high (10.6%). Younger age, early onset of homelessness, longer duration of homelessness, male gender, drug and alcohol dependence or abuse disorders, and history of traumatic brain injury were significant predictors of high and decreasing incarceration trajectories compared to low trajectory. Receiving Housing First was not significantly associated with incarceration trajectory group.ConclusionsA small subgroup of individuals with mental illness and experiences of homelessness demonstrated a persistently high and long-term incarceration trajectory. Multi-disciplinary collaborations with mental health, housing and the criminal justice systems are needed, especially for individuals at increased risk of future incarceration.The trial is registered in the ISRCTN registry (ISRCTN42520374).</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251372188"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979151","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":"Integrated Management of Co-Occurring Alcohol Use Disorder and Depression: Clinical Approaches for Concurrent Disorders.","authors":"Anees Bahji, Victor Tang, Marlon Danilewitz","doi":"10.1177/07067437251374564","DOIUrl":"10.1177/07067437251374564","url":null,"abstract":"<p><p>Co-occurring alcohol use disorder (AUD) and major depressive disorder (MDD) are common and complex conditions that significantly impact patient outcomes. The bidirectional relationship between alcohol use and depression complicates diagnosis and treatment, as alcohol exacerbates depressive symptoms and vice versa. Integrated treatment addressing both disorders simultaneously has shown better outcomes compared to sequential treatments. This article provides evidence-based clinical guidance for managing patients with co-occurring AUD and MDD, focusing on pharmacotherapy, psychotherapy and integrated care models. Pharmacologically, selective serotonin reuptake inhibitors and tricyclic antidepressants are commonly used to treat depression in individuals with AUD, while naltrexone and acamprosate are first-line medications for AUD. Combining antidepressants with AUD medications improves treatment efficacy. Psychotherapeutic interventions such as Cognitive-Behavioural Therapy (CBT) and Motivational Interviewing are essential components of treatment, focusing on addressing both alcohol use and depressive symptoms. Behavioural activation has also proven effective in treating depression while reducing alcohol cravings. Integrated care models, where both disorders are addressed simultaneously, yield the best outcomes and involve coordinated pharmacotherapy, psychotherapy and ongoing follow-up care. A case example of a 33-year-old woman with AUD and MDD highlights the success of an integrated treatment approach, where a combination of sertraline, naltrexone and CBT led to significant improvements in both mood and alcohol use. Clinicians are advised to differentiate between alcohol-induced depression and primary MDD, consider potential medication interactions, and incorporate ongoing psychotherapy and monitoring for optimal patient outcomes. This approach emphasizes the importance of addressing both conditions concurrently to achieve better long-term recovery outcomes for patients with co-occurring AUD and MDD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251374564"},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979123","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 Virtual Reality on Negative Symptoms and Quality of Life of Patients With Schizophrenia: A Meta-Analysis: Influence de la réalité virtuelle sur les symptômes négatifs et la qualité de vie des patients atteints de schizophrénie : une méta-analyse.","authors":"Shiqiu Liu, Shuaibo Tang, Youguo Tan, Bo Xiang","doi":"10.1177/07067437251372186","DOIUrl":"10.1177/07067437251372186","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia brings about diverse challenges to patients, their families and society. It is up to the healthcare system to effectively resolve these concerns and benefit all involved parties. With the emerging development and adaptation of virtual reality (VR), this may offer a new direction and potential for treating people with schizophrenia. Our goal was to employ meta-analysis to evaluate the influence of VR on the clinical outcomes and quality of life in people with schizophrenia.</p><p><strong>Methods: </strong>We performed an extensive screening of randomized controlled trials (RCTs) examining the effect of VR on the clinical outcomes in people with schizophrenia. Our search included the scientific databases PubMed, Embase, Web of Science and the Cochrane Library, and included RCTs from the date of database establishment till 1 June 2023 and we followed a strict study of inclusion and exclusion criteria. The meta-analysis was conducted in RevMan 5.4.</p><p><strong>Results: </strong>We selected 963 patients from 10 RCTs. Relative to other forms of interventions, VR therapy considerably alleviated overall clinical (SMD = -4.33, 95% CI = [-6.92, -1.74], <i>P</i> = 0.001) and negative symptomology (SMD = -1.38, 95% CI = [-2.46, -0.30], <i>P</i> = 0.01) among in people with schizophrenia. In contrast, no significant improvements were observed in positive symptoms or quality of life among these patients. Further subgroup analyses of the results indicated that there were differences in the improvement of negative symptoms among patients across the different interventions (<i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>Based on our meta-analysis, VR-based treatment regimen significantly improves overall and negative symptoms in people with schizophrenia. Further exploration is warranted to elucidate the influence of VR on patient positive symptoms and quality of life.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251372186"},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978986","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":"Exploring Mental Health Distress, Demographics, and Service Utilization Patterns Among South Asian and Non-South Asian Youth Accessing Integrated Youth Services in British Columbia, Canada: Exploration de la détresse mentale, des données démographiques et des tendances d'utilisation des services chez les jeunes d'origine sud-asiatique et non sud-asiatique qui ont recours aux services intégrés pour les jeunes en Colombie-Britannique, au Canada.","authors":"Avneet Kaur Dhillon, Christine Mulligan, Viet Dao, Hasina Samji, Suzanne Huot, Skye Barbic","doi":"10.1177/07067437251355648","DOIUrl":"10.1177/07067437251355648","url":null,"abstract":"<p><p>ObjectivesTo understand the mental health distress, demographics and service utilization patterns among South Asian and non-South Asian youth accessing integrated youth services (IYS) in British Columbia (BC), Canada.MethodsThis study used data from youth accessing services at the BC-IYS (Foundry) between April 2018 and October 2023. Descriptive statistics summarized demographic and service utilization data, with categorical variables compared using chi-squared tests and continuous variables using t-tests. A linear regression model examined the relationship between ethnicity (South Asian vs. non-South Asian) and mental health distress measured by Kessler Distress Scale (K10), stratified by gender [cisgender and transgender and non-conforming (TGNC)].ResultsThe study included 30,016 youth, among whom 5.5% (<i>n</i> = 1,652) were South Asian. South Asian youth had higher distress levels (Average K10 score: 32.1 vs. 31.3, <i>P</i> < 0.001) and lower mental health service utilization within the past year (57.1% vs. 48.4%) compared to non-south Asian youth. They were also more likely to use virtual services (30.2% vs. 19.4%). For gender, 94.5% of South Asian youth identified as cisgender and 5.1% as TGNC, compared to 14% TGNC in non-South Asians (<i>P</i> < 0.001). Regression analyses showed a significant association between ethnicity and mental health distress. This was amplified within the TGNC strata for South Asian participants compared to non-South Asian youth (<i>B</i> = 2.00, 95% CI, 0.35 to 3.66, <i>P</i> = 0.018). Younger age was associated with higher levels of mental health distress among South Asian youth in both gender strata: cisgender (<i>B</i> = -0.07, 95% CI, -0.10 to -0.03, <i>P</i> < 0.001) and TGNC (<i>B</i> = -0.14, 95% CI, -0.21 to -0.06, <i>P</i> < 0.001).ConclusionThis study reveals that South Asian youth accessing services from the BC-IYS experience higher levels of mental distress compared to non-South Asian youth. The findings highlight the need for culturally sensitive mental health services, education and policies to improve outcomes for South Asian youth in BC.Plain Language Summary TitleUnderstanding the Needs of South Asian Youth Accessing Integrated Youth Services in British Columbia, Canada.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"690-700"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555897","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":"Corrigendum to \"Factors Associated with Medico-Legal Events Resulting from Attempted Suicide by Patients in Care  Facteurs associés aux événements médico-légaux résultant de tentatives de suicide de patients en soins.\"","authors":"","doi":"10.1177/07067437251357680","DOIUrl":"10.1177/07067437251357680","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"723"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576935","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":"Emergency Psychiatry in the General Adult Population: Clinical and Training Approaches.","authors":"Bruce Fage, James M Bolton, Stephanie Bouskill, Rachel Grimminck, Jodi Lofchy","doi":"10.1177/07067437251319904","DOIUrl":"10.1177/07067437251319904","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251319904"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978886","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}