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

{"title":"Differential Functional Connectivity of Frontolimbic Circuit During Symptom Provocation in Distinct Symptom Profiles of Obsessive-Compulsive Disorder: Connectivité fonctionnelle différentielle du circuit frontolimbique durant la provocation de symptômes dans des profils symptomatiques distincts du trouble obsessionnel-compulsif.","authors":"Navya Spurthi Thatikonda, Janardhanan C Narayanaswamy, Ganesan Venkatasubramanian, Y C Janardhan Reddy, Shyam Sundar Arumugham","doi":"10.1177/07067437251328368","DOIUrl":"10.1177/07067437251328368","url":null,"abstract":"<p><p>BackgroundEmotional processing deficits and frontolimbic dysfunction have been observed in patients with obsessive-compulsive disorder (OCD), with inconsistent evidence possibly due to symptom heterogeneity. We compared the functional activation and connectivity patterns of the frontolimbic structures during symptom provocation between patients with distinct symptom profiles of OCD.MethodsThirty-seven symptomatic OCD subjects were recruited and categorized based on predominant symptom profiles to contamination/washing symptom group (OCD-C, n = 19) and taboo thoughts group (OCD-T, n = 18), along with 17 healthy controls (HCs). All subjects were evaluated with comprehensive clinical assessments and functional magnetic resonance imaging while appraising personalized disorder-specific stimuli with contrasting neutral stimuli as part of an individualized symptom provocation task. Region of interest analyses and task-dependent seed-to-voxel connectivity of the frontolimbic circuit were compared between the groups, with correction employed for multiple comparisons.ResultsOCD-C subjects had decreased task-dependent mean activation of the left amygdala (adjusted mean difference = 13.48, p= 0.03) and right hippocampus (adjusted mean difference = 13.48, p = 0.04) compared to HC. Task-modulated functional connectivity analyses revealed that OCD-C had decreased connectivity of the right hippocampus with bilateral supplementary motor cortex and anterior cingulate gyrus (T = -5.11, p = 0.04); right insula with left cerebellum (T = -5.47, p = 0.02); and left insula with inferior temporal gyrus (T = -6.27, p = 0.03) than HC. OCD-T subjects had greater connectivity of right insula with left cerebellum (T = 6.64, p < 0.001) than OCD-C and increased connectivity of medial frontal cortex with right lateral occipital cortex (T = 5.08, p < 0.001) than HC.ConclusionsContamination-related symptoms were associated with decreased activation and connectivity of amygdala and hippocampus during symptom provocation, while the taboo thoughts were associated with increased connectivity of the insular cortex and medial frontal cortex. These findings suggest that distinct neurobiological markers may underlie the clinical heterogeneity of OCD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328368"},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675063","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":"Reducing Mental Health Stigma in the Workplace: A Meta-Analysis of The Working Mind Program in Virtual Delivery Format: Réduire la stigmatisation en milieu de travail : Une méta-analyse du programme L'esprit au travail en format virtuel.","authors":"Keith S Dobson, Brittany Lindsay, Jordan Termeer, Elena Mineva, Andrew Szeto","doi":"10.1177/07067437251328366","DOIUrl":"10.1177/07067437251328366","url":null,"abstract":"<p><p>BackgroundMental health stigma in the workplace has been widely recognized, and workplace programs have been created to improve self-awareness and resiliency, while decreasing stigma. Prior meta-analyses of The Working Mind (TWM) program suggest positive benefits. The current meta-analysis was based on the shift to online delivery of TWM during the COVID-19 pandemic. It was predicted that program outcomes would be approximately the same as in prior analyses of in person delivery of the TWM program.MethodTWM program was delivered by expert trainers to a total of 1,159 participants across six workplace settings. Participants provided informed consent and survey data, prior to, just after and 3 months after the program. Outcomes included stigma, resiliency and readiness for change. Standardized assessments were employed, consistent with prior program analyses.ResultsSignificant reductions in stigma and increases in self-reported resiliency occurred, with immediate overall effect sizes of 0.33 and 0.40, respectively. Some variability among workplace settings was observed. Males had a somewhat better result than females and people who reported worse mental health at program initiation had somewhat better results than others, but these were modest effects. The results were largely stable until the 3-month follow-up assessment period. Attrition across the study interval was considerable.ConclusionsThe virtual delivery of TWM yielded meta-analytic results that were comparable to previous in person outcomes, both in terms of immediate and 3-month assessment intervals. Some variability in outcomes was noted, and some return towards baseline was observed at the 3-month follow-up period. The issue of attrition was also noted, possibility due to effects of online fatigue and the voluntary nature of the study. Suggestions for further study of program effects are given, and workplace wellness programs are encouraged.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328366"},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659775","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 of Major Depressive Disorder Relapse and Effectiveness of Pharmacologic and Psychological Interventions in Primary Care: A Systematic Review and Meta-Analysis: Incidence de la rechute du trouble dépressif majeur et efficacité des interventions pharmacologiques et psychologiques en soins primaires : revue systématique et méta-analyse.","authors":"Waseem Abu-Ashour, Stephanie Delaney, Alison Farrell, John-Michael Gamble, John Hawboldt, Joanna E M Sale","doi":"10.1177/07067437251322401","DOIUrl":"10.1177/07067437251322401","url":null,"abstract":"<p><p>ObjectiveThis research aims to investigate the relapse rates of major depressive disorder (MDD) within primary care and evaluate the efficacy of relapse prevention therapies. Despite primary care being the common point of contact for MDD patients, there are limited studies around this.MethodsWe included randomized controlled trials and observational studies examining MDD relapse incidence and the effect of pharmacological and non-pharmacological interventions in preventing relapse in primary care. Databases; Medline via Ovid, EMBASE, The Cochrane Library, PsycInfo (ebsco), and Clinical Trials.gov were searched from their inception until September 7, 2022. Joanna Briggs Institute (JBI) appraisal instrument for methodological quality assessment was used. A proportional data analysis estimated the MDD relapse incidence. Therapy effectiveness results were shown as odds ratios with 95% confidence intervals, with heterogeneity explored via subgroup analysis.ResultsOut of the reviewed studies, 35 met the eligibility criteria. Quality appraisal scores varied between 73% and 96%. MDD relapse incidence was divided into subgroups, revealing that both pharmacotherapy and non-pharmacotherapy led to a similar decrease in relapse rates with combination therapies showing further reduction in relapse. Subgroup analyses by study design, follow-up length, date of study and quality of study also yielded noteworthy findings.ConclusionOur findings showed that MDD relapse rates in primary care settings can be effectively reduced by pharmacotherapy, non-pharmacotherapy, or combination therapy. Some psychological interventions might also reduce relapse likelihood. More studies are needed on individual and combined treatments over longer periods to understand their long-term impacts on MDD relapse in primary care.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251322401"},"PeriodicalIF":3.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651709","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":"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><p>ObjectiveWe 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).MethodsThe 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.ResultsWe 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.ConclusionsUsing 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.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251322399"},"PeriodicalIF":3.3,"publicationDate":"2025-03-13","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}

{"title":"Impact of Stress on the Endocannabinoid System: A [¹¹C]-CURB Positron Emission Tomography Study in Early Psychosis: Les effets du stress sur le système endocannabinoïde : étude par tomographie par émission de positons avec l'indicateur radioactif [11C-CURB] dans la psychose précoce.","authors":"Ana Weidenauer, Ranjini Garani, Paula Campos Oller, Maira Belén Blasco, Pablo M Rusjan, Romina Mizrahi","doi":"10.1177/07067437241300958","DOIUrl":"10.1177/07067437241300958","url":null,"abstract":"<p><strong>Background: </strong>Stress and traumatic experiences are well-established risk factors for psychiatric disorders. Stressful events can induce symptoms of anxiety and depression and may lead to overt psychosis, especially when there is an innate biological vulnerability. This study explores the role of the stress-regulating endocannabinoid system, specifically the activity of the enzyme fatty acid amid hydrolase (FAAH), a key regulatory enzyme for endocannabinoids, in association with stress by analysing data from healthy individuals and patients with psychosis.</p><p><strong>Methods: </strong>We performed a post-hoc exploratory analysis on 65 positron emission tomography scans using the selective FAAH radioligand [¹¹C]CURB, encompassing 30 patients with psychosis (6 female) and 35 healthy controls (19 female). The study aimed to examine the association between FAAH activity and stressful life events, assessed through the Recent Life Events, Survey of Life Experiences, and Hassles and Uplifts Scale.</p><p><strong>Results: </strong>There was a significant difference regarding the number of recent stressors with higher levels in patients compared to healthy subjects (Survey of Life Experiences: <i>t </i>= 4.88, <i>p</i> < 0.001, hassles: <i>t </i>= 3.14, <i>p</i> = 0.003), however there was no significant relationship of brain FAAH activity and stressful life events in any of the applied scales across groups (Recent Life Events: <i>F</i>_1,57= 0.07, <i>p</i> = 0.80; Survey of Life Experiences: <i>F</i>_1,57= 1.75, <i>p</i> = 0.19; hassles: <i>F</i>_1,56= 1.06, <i>p</i> = 0.31). Linear mixed models performed separately for each group revealed that there was a positive association between FAAH activity and Recent Life Events in patients with psychosis only (<i>F</i>_1,25= 8.07, <i>p</i> = 0.009).</p><p><strong>Conclusions: </strong>Our data reveal a significant disparity in recent stressors between the two groups, and a correlation between brain FAAH activity and stressful life events in patients with psychosis only. This suggests a complex interplay between stress and the endocannabinoid system.</p><p><strong>Plain language summary title: </strong>How Stress Affects the Brain’s Endocannabinoid System in Early Psychosis: A PET Study.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"251-259"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780922","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":"Clinical Characteristics of Inpatients with Schizophrenia Spectrum Disorder Treated with Electroconvulsive Therapy: A Population-Level Cross-Sectional Study: Titre: Caractéristiques cliniques des patients hospitalisés présentant un trouble du spectre de la schizophrénie et traités par électrochocs : Une étude de population transversale.","authors":"Tyler S Kaster, Amreen Babujee, Isobel Sharpe, Taeho Greg Rhee, Tara Gomes, Paul Kurdyak, George Foussias, Duminda Wijeysundera, Daniel M Blumberger, Simone N Vigod","doi":"10.1177/07067437241290181","DOIUrl":"10.1177/07067437241290181","url":null,"abstract":"<p><strong>Objective: </strong>Electroconvulsive therapy (ECT) is an evidence-based treatment for schizophrenia when anti-psychotic medications do not sufficiently control symptoms of psychosis or rapid response is required. Little is known about how it is used in routine clinical practice. The aim of this study was to identify the association of demographic and clinical characteristics with administration of ECT for schizophrenia spectrum disorders (SSD).</p><p><strong>Methods: </strong>Among psychiatric inpatients with a diagnosis of SSD in Ontario, Canada (2006-2023), patient-level socio-demographic and clinical characteristics were described in those who did and did not receive ECT. We used multi-variable logistic regression to assess the association between patient-level characteristics and administration of ECT during index hospitalization.</p><p><strong>Results: </strong>From 164,632 admissions, 2,168 (1.3%) involved exposure to ≥1 inpatient ECT procedure. Compared to those not receiving ECT, those receiving ECT were older, had higher rates of pre-admission medication use, medical and psychiatric comorbidities, outpatient mental health service use, but lower rates of substance use disorders. In the multi-variable logistic regression model, patient-level characteristics most strongly associated with receiving inpatient ECT were the presence of catatonia (odds ratio [OR]: 5.83; 95% confidence interval [95% CI]: 4.01-8.46), comorbid depression (OR: 2.49; 95% CI: 2.07-2.98), obsessive-compulsive disorder (OR: 2.16; 95% CI: 1.55-3.00), while characteristics most strongly associated with not receiving inpatient ECT were myocardial infarction (OR: 0.44; 95% CI: 0.20-0.95) and family conflict towards patient (OR: 0.47; 95% CI: 0.31-0.71). Neither severity of psychotic symptoms, non-command auditory hallucinations nor delusions were associated with administration of ECT.</p><p><strong>Conclusions: </strong>While characteristics associated with the use of ECT are generally consistent with the indications for ECT (e.g., catatonia, mood disorders), ECT is rarely used amongst individuals with SSD. Severity of psychotic symptoms was not associated with the use of inpatient ECT suggesting an opportunity to increase the use of ECT in this population.</p><p><strong>Plain language summary title: </strong>Patient characteristics associated with receiving electroconvulsive therapy in schizophrenia and other psychotic illnesses.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"194-208"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633245","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":"Promoting Evidence-Based Tobacco Cessation Treatment in Community Mental Health Clinics: Results of a Pilot Implementation Study: Promouvoir le traitement de sevrage tabagique fondé sur des données probantes dans les cliniques communautaires de santé mentale : résultats d'une étude pilote de mise en œuvre.","authors":"Faith Dickerson, Tyler Fink, Stacy Goldsholl, Arlene Dalcin, Benjamin Eidman, Christina T Yuan, Joseph V Gennusa, Corinne Cather, A Eden Evins, Nae-Yuh Wang, Emma M McGinty, Gail L Daumit","doi":"10.1177/07067437241309678","DOIUrl":"10.1177/07067437241309678","url":null,"abstract":"<p><strong>Objective: </strong>Tobacco smoking is the leading cause of preventable death among individuals with serious mental illness (SMI) but few persons with SMI are offered smoking cessation treatment. The purpose of this study was to pilot-test a multicomponent intervention to increase the delivery of evidence-based smoking cessation treatment in community mental health clinics (CMHCs).</p><p><strong>Method: </strong>This study was carried out at five CMHCs in Maryland involving clinicians who participated in training in smoking cessation. Other implementation activities included the provision of a treatment protocol, coaching, expert consultation, and organizational strategy meetings. The primary outcome was a change in clinicians' knowledge and self-efficacy about smoking cessation. Secondary outcomes included documentation of evidence-based smoking cessation practices including assessment of smoking status and readiness to quit, and provision of smoking cessation treatment over the course of the 12-month intervention period.</p><p><strong>Results: </strong>A total of 91 clinicians participated in the study. Data were available on 6,011 clients. Clinicians' scores on the knowledge and self-efficacy measures increased modestly over the course of the implementation period. Overall, 57% of clients had their smoking status assessed; 81% of current smokers were evaluated about their willingness to quit; 82% of those willing to quit within 90 days received behavioral counseling, and 36% were prescribed or given smoking cessation pharmacotherapy. Clinicians rated the smoking cessation program highly in terms of acceptability, appropriateness, and feasibility.</p><p><strong>Conclusions: </strong>Clinicians at CMHCs were engaged by and participated in training and implementation activities around smoking cessation practices which they then delivered to a substantial portion of clients in their care. The results of this study provide important data for the future planning of testing implementation strategies to scale up tobacco cessation treatment in this population in outpatient mental health settings.</p><p><strong>Plain language summary title: </strong>Implementing Smoking Cessation Treatment in Community Mental Health Clinics.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"171-181"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016764","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 Dysregulation of the Glymphatic System in Patients with Psychosis Spectrum Disorders Minimally Exposed to Antipsychotics: La dérégulation du système glymphatique en présence de troubles psychotiques chez des patients peu exposés à des antipsychotiques.","authors":"Vittal Korann, Kristoffer J Panganiban, Nicolette Stogios, Gary Remington, Ariel Graff-Guerrero, Araba Chintoh, Margaret K Hahn, Sri Mahavir Agarwal","doi":"10.1177/07067437241290193","DOIUrl":"10.1177/07067437241290193","url":null,"abstract":"<p><strong>Objective: </strong>The pathophysiological mechanisms influencing psychosis spectrum disorders are largely unknown. The glymphatic system, which is a brain waste clearance pathway, has recently been implicated in its pathophysiology and has also been shown to be disrupted in various neurodegenerative and vascular diseases. Initial studies examining the glymphatic system in psychosis spectrum disorders have reported disruptions, but the findings have been confounded by medication effects as they included antipsychotic-treated patients. In this study, we used diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) as a technique to measure the functionality of the glymphatic system in a sample of antipsychotic-minimally exposed patients with psychosis spectrum disorders and healthy controls.</p><p><strong>Methods: </strong>The study included 13 antipsychotic-minimally exposed (2 weeks antipsychotic exposure in the past 3 months/lifetime) patients with psychosis spectrum disorders and 114 healthy controls. We quantified water diffusion metrics along the <i>x</i>-, <i>y</i>-, and <i>z</i>-axes in both projection and association fibres to derive the DTI-ALPS index, a proxy for glymphatic activity. Between-group differences were analyzed using two-way ANCOVA controlling for age and sex. Partial correlations were used to assess the association between the ALPS index and clinical variables.</p><p><strong>Results: </strong>Analyses revealed that antipsychotic-minimally exposed psychosis spectrum disorder patients had a lower DTI-ALPS index value than healthy controls in both hemispheres and the whole brain (all <i>P</i> < 0.005). Significant differences were also observed between the <i>x</i> and <i>y</i> projections/associations between patients and healthy controls (<i>P</i> < 0.001). Furthermore, we did not find any significant correlations (all <i>P</i> > 0.05) between the DTI-ALPS index with age, body mass index, symptomatology, and metabolic parameters.</p><p><strong>Conclusion: </strong>This study shows that the glymphatic system is dysregulated in antipsychotic-minimally exposed patients with psychosis spectrum disorders. Understanding the mechanisms that influence the glymphatic system may help to understand the pathophysiology of psychosis spectrum disorders as proper waste clearance is needed for normal brain functioning.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"260-270"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481430","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":"Cannabis Use Cessation and the Risk of Psychotic Disorders: A Case-Control Analysis from the First Episode Case-Control EU-GEI WP2 Study: L'arrêt de l'utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l'étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques.","authors":"Benjamin W Bond, Bea Duric, Edoardo Spinazzola, Giulia Trotta, Edward Chesney, Zhikun Li, Diego Quattrone, Giada Tripoli, Charlotte Gayer-Anderson, Victoria Rodriguez, Laura Ferraro, Caterina La Cascia, Ilaria Tarricone, Andrei Szöke, Celso Arango, Julio Bobes, Miquel Bernardo, Cristina Marta Del-Ben, Paulo Rossi Menezes, Jean-Paul Selten, Bart P F Rutten, Lieuwe de Haan, Simona Stilo, Franck Schürhoff, Baptiste Pignon, Tom P Freeman, Evangelos Vassos, Robin M Murray, Isabelle Austin-Zimmerman, Marta Di Forti","doi":"10.1177/07067437241290187","DOIUrl":"10.1177/07067437241290187","url":null,"abstract":"<p><strong>Objectives: </strong>To establish whether the risk of psychotic disorders in cannabis users changes with time following cannabis cessation using data from the European Network of National Networks studying Gene-Environment Interactions in Schizophrenia (EU-GEI) case-control study.</p><p><strong>Methods: </strong>The EU-GEI case-control study collected data from first episode psychosis patients and population controls across sites in Europe and Brazil between May 2010 and April 2015. Adjusted logistic regressions were applied to examine whether the odd of psychosis case status changed: (1) with time following cannabis cessation and (2) across different cannabis use groups.</p><p><strong>Results: </strong>Psychosis risk declined following cessation of cannabis use (β = -0.002; 95% CI -0.004 to 0.000; <i>P</i> = 0.067). When accounting for duration of use, this effect remained (β = -0.003; 95% CI -0.005 to -0.001; <i>P</i> = 0.013). However, in models adjusting for frequency and potency of use the result was not significant. Analysis of different cannabis use groups indicated that ex-users who stopped 1 to 4 weeks previously had the highest risk for psychotic disorder compared to never users (OR = 6.89; 95% CI 3.91-12.14; <i>P</i> < 0.001); risk declined for those who stopped 5 to 12 weeks previously (OR = 2.70; 95% CI 1.73-4.21; <i>P</i> < 0.001) and 13 to 36 weeks previously (OR = 1.53; 95% CI 1.00-2.33; <i>P</i> = 0.050). Ex-users who stopped 37 to 96 weeks (OR = 1.01; 95% CI 0.66-1.57; <i>P</i> = 0.949), 97 to 180 weeks (OR = 0.73; 95% CI 0.45-1.19; <i>P</i> = 0.204), and 181 weeks previously or more (OR = 1.18; 95% CI 0.76-1.83; <i>P</i> = 0.456) had similar psychosis risk to those who had never-used cannabis.</p><p><strong>Conclusion: </strong>Risk of psychotic disorder appears to decline with time following cannabis cessation, receding to that of those who have never used cannabis after 37 weeks or more of abstinence. Although, preliminary results suggest that frequent users of high potency types of cannabis might maintain an elevated risk compared to never users even when abstaining for longer than 181 weeks.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"182-193"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985578","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":"Brain Age Gap as a Predictor of Early Treatment Response and Functional Outcomes in First-Episode Schizophrenia: A Longitudinal Study: L'écart d'âge cérébral comme prédicteur de la réponse en début de traitement et des résultats fonctionnels dans un premier épisode de schizophrénie : une étude longitudinale.","authors":"Lejia Fan, Zhenmei Zhang, Xiaoqian Ma, Liangbing Liang, Liu Yuan, Lijun Ouyang, Yujue Wang, Zongchang Li, Xiaogang Chen, Ying He, Lena Palaniyappan","doi":"10.1177/07067437241293981","DOIUrl":"10.1177/07067437241293981","url":null,"abstract":"<p><strong>Objectives: </strong>Accelerated brain aging, i.e., the age-related structural changes in the brain appearing earlier than expected from one's chronological age, is a feature that is now well established in schizophrenia. Often interpreted as a feature of a progressive pathophysiological process that typifies schizophrenia, its prognostic relevance is still unclear. We investigate its role in response to antipsychotic treatment in first-episode schizophrenia.</p><p><strong>Methods: </strong>We recruited 49 drug-naive patients with schizophrenia who were then treated with risperidone at a standard dose range of 2-6 mg/day. We followed them up for 3 months to categorize their response status. We acquired T1-weighted anatomical images and used the XGboost method to evaluate individual brain age. The brain age gap (BAG) is the difference between the predicted brain age and chronological age.</p><p><strong>Results: </strong>Patients with FES had more pronounced BAG compared to healthy subjects, and this difference was primarily driven by those who did not respond adequately after 12 weeks of treatment. BAG did not worsen significantly over the 12-week period, indicating a lack of prominent brain-ageing effect induced by the early antipsychotic exposure per se. However, highly symptomatic patients had a more prominent increase in BAG, while patients with higher BAG when initiating treatment later showed lower gains in global functioning upon treatment, highlighting the prognostic value of BAG measures in FES.</p><p><strong>Conclusions: </strong>Accelerated brain aging is a feature of first-episode schizophrenia that is more likely to be seen among those who will not respond adequately to first-line antipsychotic use. Given that early poor response indicates later treatment resistance, measuring BAG using structural MRI in the first 12 weeks of treatment initiation may provide useful prognostic information when considering second-line treatments in schizophrenia.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"240-250"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633244","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}