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

{"title":"The Complex Journey of Women in Perinatal Psychiatric Care: Susceptibility to Illness Onset, Comorbidity and Clinical Trajectories: Le parcours complexe des femmes en psychiatrie périnatale : vulnérabilité, comorbidités et trajectoires cliniques.","authors":"Alexandra Painchaud, Marie-Josée Poulin, Célia Matte-Gagné, Chantal Mérette","doi":"10.1177/07067437251328347","DOIUrl":"https://doi.org/10.1177/07067437251328347","url":null,"abstract":"<p><p>BackgroundMore than one in five women deal with a psychiatric disorder during the perinatal period. Whereas perinatal depression is well documented, there is still little research on the full range of perinatal psychiatric disorders and their clinical evolution across this whole period. The present study investigated the susceptibility to psychiatric illness during pregnancy and up to one year postpartum. We aimed to identify the most frequent disorders and comorbidities arising in each perinatal period. We outlined the clinical trajectories of these disorders in terms of evolution across past history, pregnancy and postpartum.MethodThrough a retrospective longitudinal design, data were collected in 2019-2020 from the medical records of the cohort of 964 women who required care in a tertiary perinatal psychiatry clinic located in Quebec City (Canada) between 2004 and 2020. Incidence rates of the full range of psychiatric disorders were estimated per period and their evolution across time identified clinical trajectories.ResultsDuring pregnancy, 34 different disorders were newly diagnosed with incidence rates ranging from 0.1% to 15.5% (45.6% of women having had at least one disorder diagnosed during pregnancy) whereas, during postpartum, 36 disorders were newly diagnosed with incidence rates ranging from 0.1% to 31.0% (67.5% of women having had at least one disorder diagnosed during postpartum). For most disorders, rates were significantly higher in postpartum than in pregnancy. A woman could develop multiple disorders during a given perinatal period: this comorbidity involved various combinations of diagnoses in 28% of women during pregnancy and 38% during postpartum. We outlined 52 different clinical trajectories from past history to postpartum, underlining the heterogeneity of the perinatal course.ConclusionsPregnancy is a susceptible period for women with past psychiatric histories whereas postpartum could trigger a new illness in women without a past history or pregnancy-onset psychiatric disorder.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328347"},"PeriodicalIF":3.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029707","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":"Adaptation of a Psychosocial Intervention for Canadian Youth at Clinical High Risk for Psychosis: Adaptation d'une intervention psychosociale pour les jeunes à haut risque clinique de psychose au Canada.","authors":"Yun Lu, Thea L Hedemann, Lisa D Hawke, Augustina Ampofo, Riley Goldsmith, Nicole Kozloff, Gillian Strudwick, Michael Kiang, David Castle, George Foussias, Muhammad Omair Husain","doi":"10.1177/07067437251328357","DOIUrl":"https://doi.org/10.1177/07067437251328357","url":null,"abstract":"<p><p><b>Aim:</b> This paper provides a detailed account of the process and outcomes involved in adapting a psychosocial intervention - the Optimal Health Program (OHP) - for young individuals who are at clinical high risk (CHR) for psychosis. This adaptation process included the active participation of youth with lived experience of psychosis spectrum disorder (CHR and first episode psychosis). <b>Methods:</b> A six-member advisory group consisting of youth with lived experience was established. The group convened weekly to review the OHP workbook in detail. This initiative was supported by a dedicated research assistant. Adherence to established guidelines for engaging with youth was maintained throughout. Following the completion of the adaptation, a review session was conducted to gather feedback. <b>Results:</b> The primary adaptations made to the intervention can be categorized as follows: 1) modification of language; 2) tailoring to the CHR population; 3) incorporation of personal stories; 4) emphasis on personalized recovery; 5) inclusion of 'guiding and supportive activities'; 6) enhancement of graphic design. Suggestions for a digital application were not integrated due to their scope extending beyond the aims of the current project. An assessment of the engagement process revealed that the involvement of youth was meaningful and impactful. <b>Conclusions:</b> Through sustained and meaningful engagement with youth with lived experience, the present project adapted OHP for CHR individuals. The resulting intervention materials are anticipated to be closely aligned with the distinct needs and priorities of young CHR individuals. Subsequent endeavours in developing appropriate interventions that aim to improve outcomes for this population should involve engaging and collaborating with individuals with lived experience. We are currently in the process of evaluating the feasibility, acceptability, and preliminary efficacy of delivering OHP to individuals with CHR in a clinical trial.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251328357"},"PeriodicalIF":3.3,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060447","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":"Ketamine and Perinatal Mental Health: Problems and Potentials.","authors":"Jennifer Swainson","doi":"10.1177/07067437251331514","DOIUrl":"https://doi.org/10.1177/07067437251331514","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251331514"},"PeriodicalIF":3.3,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054534","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":"Mapping Insight Dimensions and Symptom Dynamics in Schizophrenia: A Data-Driven Network Approach: Cartographie des dimensions d'insight et de la dynamique symptomatique dans la schizophrénie: une approche par réseau fondée sur les données.","authors":"Jesse Rae, Katie M Lavigne, Geneviève Sauvé, Martin Lepage, Delphine Raucher-Chéné","doi":"10.1177/07067437251329074","DOIUrl":"10.1177/07067437251329074","url":null,"abstract":"<p><p>ObjectivesPatients with <i>schizophrenia spectrum disorders</i> (SSD) present with cognitive, behavioral, and emotional difficulties. Affected individuals often exhibit poor insight into aspects of their illness, such as awareness of the illness itself or the need for treatment, which can hinder treatment adherence and complicate clinical outcomes. This study aimed to investigate the relationships between clinical symptoms and dimensions of insight in SSD using a network approach, which captures direct and indirect relationships among variables. We hypothesized that illness awareness would correlate negatively with positive symptoms and positively with depressive symptoms, and that positive symptoms would have the strongest influence on the network.MethodsData were collected from 142 individuals diagnosed with SSD. Insight was measured using the Birchwood Insight Scale (IS) across three dimensions: illness awareness, symptom re-labelling, and awareness of the need for treatment. Symptoms were evaluated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, the Calgary Depression Scale and the Hamilton Anxiety Scale. Network analysis was employed to explore interconnections (edges) between variables (nodes) and identify influential variables through centrality measures (strength, betweenness, closeness).ResultsA significant positive connection was found between illness awareness and depressive symptoms. Anxiety and depressive symptoms were identified as the most central and influential variables within the network. Treatment awareness showed greater centrality than illness awareness, indicating this dimension's potential importance in influencing symptom dynamics in a clinical profile.ConclusionsAnalyzing a more extensive network that includes treatment adherence and cognitive domains affected in SSD could enhance and validate the understanding of the cascading effects of symptoms and insight dimensions, allowing for more tailored treatments.Plain Language Summary TitleInterconnections between levels of awareness and clinical symptoms in schizophrenia and related disorders.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"301-311"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675070","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":"Depressive Symptoms and Epistemological Approaches: A Qualitative Study Among Psychiatrists: Symptômes dépressifs et approches épistémologiques : une étude qualitative auprès de psychiatres.","authors":"Clémence Piaux, Céline Bourquin, Friedrich Stiefel","doi":"10.1177/07067437251317245","DOIUrl":"10.1177/07067437251317245","url":null,"abstract":"<p><p>BackgroundThe study aimed to investigate how psychiatrists handle the diagnosis and treatment of depression in the adult.ParticipantsPsychiatrists (<i>N</i> = 17) of the French-speaking Canton of Vaud (Switzerland), working in public institutions or in private sector (cabinets), having different theoretical backgrounds depending on their training (systemic, cognitive-behavioural or psychodynamic) and different duration of clinical experiences were included in the study.MethodsA clinical vignette presenting a young man with depressive symptoms of moderate intensity having experienced multiples losses during the development and recent past was presented to the participants. Participants were invited to read the vignette and react (\"thinking aloud\"), followed by an invitation to elaborate on the diagnosis and treatment.ResultsA heterogeneous approach towards the diagnosis and treatment of depression was observed. Without a consensus regarding the diagnosis of depressions, two distinct ways to understand the clinical vignette emerged: one pathogenic, identifying the underlying causes of the depressive symptoms, and the other nosological, based on diagnostic criteria. Consequently, proposition for treatment also diverged ranging from psychotherapy, psychotropic medication, complementary and alternative treatments, and paramedical approaches such as ergo- and socio-therapy, at times leaving the choice up to the patient. Possible explanations for this diversity are a more or less strict adherence to diagnostic criteria used by the psychiatrists, be they ICD or DSM, the double training as psychiatrist and psychotherapist which is mandatory in Switzerland, a certain prudence regarding psychiatric diagnoses by fear of stigmatisation, attention to the therapeutic alliance or divergent views on the theoretical and conceptual understanding of depression.ConclusionThe results of this study underline the importance to include the epistemology of psychiatric disorders in training to raise awareness and conscientization regarding the influence of epistemological aspects on attitudes and approaches to the diagnosis and treatment of depression and other psychiatric disorders.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"320-327"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434409","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":"Long-Term Impact of the Bloor Viaduct Suicide Barrier on Suicides in Toronto: A Time-Series Analysis: Effet à long terme de la barrière anti-suicide du viaduc Bloor sur les suicides à Toronto : une analyse chronologique.","authors":"Mark Sinyor, Vera Yu Men, Prudence Po Ming Chan, Daniel Sanchez Morales, Anthony J Levitt, Ayal Schaffer","doi":"10.1177/07067437241293978","DOIUrl":"10.1177/07067437241293978","url":null,"abstract":"<p><p>BackgroundA suicide prevention barrier was installed at Toronto's Bloor Viaduct bridge in 2003. It was associated with short-term location substitution, possibly mediated by media effects that did not persist over 1 decade. The long-term impact of the barrier is unknown.MethodsWe examined rates of suicides by jumping from the Bloor Viaduct, other bridges and by other methods using coroner's records in Toronto (1998-2020). We used interrupted time-series Poisson regression analyses to model changes in quarterly bridge-related suicides after barrier installation. A secondary analysis explored the potential substitution effects of suicide by other methods.ResultsOf 5219 suicides from 1998 to 2020, 303 were by jumping from bridges. After controlling for covariates, installation of the Bloor Viaduct suicide barrier was associated with a 49% step decrease in bridge-related suicide in the next quarter in Toronto (incidence rate ratio [IRR] = 0.51, 95% CI, 0.30 to 0.86) with no rebound increase in bridge-related suicide during the subsequent 17 years after the original drop (IRR = 0.99, 95% CI, 0.96 to 1.03). There was also no associated change in suicides by other methods after the barrier (IRR = 1.04, 95% CI, 0.90 to 1.20).ConclusionsContrary to initial findings, these results indicate an enduring suicide prevention effect of the Bloor Viaduct suicide barrier. They support the long-term utility of structural interventions at high-frequency sites for suicide.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"328-334"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584954","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":"French Validation of the Brief Negative Symptom Scale (BNSS).","authors":"Lucie Métivier, Maxime Tréhout, Elise Leroux, Maud Rothärmel, Sonia Dollfus","doi":"10.1177/07067437251328350","DOIUrl":"10.1177/07067437251328350","url":null,"abstract":"<p><p>ObjectivesThis study aims to validate the French version of the Brief Negative Symptom Scale (BNSS) by assessing its psychometric properties in a population of patients with schizophrenia or schizoaffective disorder.Methods73 patients with schizophrenia or schizoaffective disorder were included. Participants were evaluated using the BNSS, the Positive and Negative Syndrome Scale (PANSS), and the Self-Evaluation of Negative Symptoms (SNS). The internal consistency of the BNSS was measured using Cronbach's alpha, structural validity was assessed through exploratory factor analysis, and construct validity was evaluated with Spearman correlations between BNSS scores, the negative subscale of the PANSS, the total SNS score, the positive subscale of the PANSS, and PANSS items evaluating insight and depressive mood.ResultsThe internal consistency of the BNSS was excellent (Cronbach's alpha = 0.93). Exploratory factor analysis revealed two factors corresponding to the motivational and expressive dimensions of negative symptoms. Significant positive correlations were found between total BNSS scores and the negative subscale of the PANSS (Rho = 0.77; <i>p</i> < 0.001), as well as with SNS scores (Rho = 0.55; <i>p</i> < 0.001). No correlation was observed between total BNSS scores and the positive subscales of the PANSS (Rho = 0.09; <i>p</i> = 0.41). However, significant positive correlations were noted with the PANSS item assessing depression (Rho = 0.28; <i>p</i> = 0.015) and insight (Rho = 0.43; <i>p</i> < 0.001).ConclusionThe French version of the BNSS has demonstrated strong psychometric properties and is suitable for clinical and research use.Plain Language Summary TitleValidation d'une échelle d'évaluation des symptômes négatifs, la « Brief Negative Symptom Scale » (BNSS).</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"312-319"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675067","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.Plain Language Summary TitleOutcomes of a virtual program to address mental Health Stigma in the workplace.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"278-288"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","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":"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":"289-300"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","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":"Polygenic Risk Score Analysis of Antidepressant Treatment Outcomes: A CAN-BIND-1 Study Report: Analyse des résultats du traitement antidépresseur à l'aide des scores de risque polygéniques : Rapport sur l'étude CAN-BIND-1.","authors":"Leen Magarbeh, Samar S M Elsheikh, Farhana Islam, Victoria S Marshe, Xiaoyu Men, Emytis Tavakoli, Martin Kronenbuerger, Stefan Kloiber, Benicio N Frey, Roumen Milev, Claudio N Soares, Sagar V Parikh, Franca Placenza, Stefanie Hassel, Valerie H Taylor, Francesco Leri, Pierre Blier, Rudolf Uher, Faranak Farzan, Raymond W Lam, Gustavo Turecki, Jane A Foster, Susan Rotzinger, Sidney H Kennedy, Daniel J Müller","doi":"10.1177/07067437251329073","DOIUrl":"10.1177/07067437251329073","url":null,"abstract":"<p><p>ObjectiveThe genetic architecture of antidepressant response is poorly understood. This study investigated whether polygenic risk scores (PRSs) for major psychiatric disorders and a personality trait (neuroticism) are associated with antidepressant treatment outcomes.MethodsWe analysed 148 participants with major depressive disorder (MDD) from the Canadian Biomarker Integration Network for Depression-1 (CAN-BIND-1) cohort. Participants initially received escitalopram (ESC) monotherapy for 8 weeks. Nonresponders at week 8 received augmentation with aripiprazole (ARI), while responders continued ESC until week 16. Primary outcomes were remission status and symptom improvement measured at weeks 8 and 16. At week 16, post-hoc stratified analyses were performed by treatment arm (ESC-only vs. ESC + ARI). Eleven PRSs derived from genome-wide association studies of psychiatric disorders (e.g., MDD and post-traumatic stress syndrome (PTSD)) and neuroticism, were analysed for associations with these outcomes using logistic and linear regression models.ResultsAt week 8, a higher PRS for PTSD was nominally associated with a lower probability of remission (odds ratio (OR) = 0.08 [0.014-0.42], empirical <i>p</i>-value = 0.017) and reduced symptom improvement (beta (standard error) = -29.15 (9.76), empirical <i>p</i>-value = 0.019). Similarly, a higher PRS for MDD was nominally associated with decreased remission probability (OR = 0.38 [0.18-0.78], empirical <i>p</i>-value = 0.044). However, none of the results survived multiple testing corrections. At week 16, the stratified analysis for the ESC-only group revealed that a higher PRS for MDD was associated with increased remission probability (empirical <i>p-</i>value = 0.034) and greater symptom improvement (empirical <i>p</i>-value = 0.02). In contrast, higher PRSs for schizophrenia (empirical <i>p</i>-value = 0.013) and attention-deficit hyperactivity disorder (empirical <i>p</i>-value = 0.032) were associated with lower symptom improvement. No significant associations were observed in the ESC + ARI group.ConclusionsThese findings suggest that PRSs may influence treatment outcomes, particularly in ESC monotherapy. Replication in larger studies is needed to validate these observations.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251329073"},"PeriodicalIF":3.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744413","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}