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

{"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><strong>Background: </strong>A 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.</p><p><strong>Methods: </strong>We 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.</p><p><strong>Results: </strong>Of 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).</p><p><strong>Conclusions: </strong>Contrary 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":"7067437241293978"},"PeriodicalIF":4.3,"publicationDate":"2024-11-05","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":"Formal Thought Disorders and Neurocognition in Treatment-Resistant Schizophrenia: Trouble du cours de la pensée et neurocognition dans la schizophrénie réfractaire.","authors":"Mohammed Alarabi, Leah Burton, Valerie Powell, Tanner Isinger, Sri Mahavir Agarwal, Gary Remington","doi":"10.1177/07067437241293985","DOIUrl":"10.1177/07067437241293985","url":null,"abstract":"<p><strong>Objective: </strong>Formal thought disorders (FTDs), a core feature of schizophrenia, have been subdivided into positive and negative types, and are clinically assessed by examining speech (objective) or patient introspection (subjective). Despite being associated with poorer treatment response and worse outcomes, FTDs have been understudied in patients with schizophrenia, in particular treatment-resistant schizophrenia (TRS) or schizoaffective disorder. We aimed to explore the relationship between the severity of positive and negative FTDs and neurocognition as well as social/occupational functioning in this clinical subgroup.</p><p><strong>Method: </strong>This was a retrospective chart review conducted at the Clozapine Clinic at the Centre for Addiction and Mental Health, Toronto, Canada. We reviewed charted standardized assessment of FTDs using the Thought and Language Disorder (TALD) scale, neurocognition using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), and functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) between October 2022 and June 2023. Following the original factor structure of the TALD, we computed 4- factor scores that combined positive or negative and objective or subjective FTDs. We then explored the correlation between the scores from each TALD factor and the neurocognition and functioning scores.</p><p><strong>Results: </strong>We analysed data for 23 outpatients on clozapine. After the Bonferroni adjustment, total TALD scores, indicating overall severity of FTDs, were strongly and inversely correlated with SOFAS scores (<i>p</i> < 0.001). A strong inverse correlation was found between the objective positive TALD factor and Letter-Number Span verbal working memory scores, <i>r</i>(21) = -0.63, <i>p</i> < 0.001.</p><p><strong>Conclusions: </strong>Our results demonstrate the strong relationship between FTDs, neurocognition, and social/occupational functioning in a sample of TRS outpatients. Within the cognitive domains assessed, verbal working memory impairment had the strongest correlation with positive FTDs, such as derailment or tangentiality. These findings highlight the value of employing standardized psychopathological scales for FTDs in clinical practice.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241293985"},"PeriodicalIF":4.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577160","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":"Psychosis and Gender: A Focus on Women in the Global South.","authors":"Sarah Barber, Adiyam Mulushoa, Charlotte Hanlon, Ashok Malla","doi":"10.1177/07067437241295301","DOIUrl":"10.1177/07067437241295301","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241295301"},"PeriodicalIF":4.3,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570082","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":"Efficacy and Safety of Modafinil for Treatment of Amphetamine-Type Stimulant Use Disorder: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials: Efficacité et innocuité du modafinil pour le traitement des troubles liés à l'usage de stimulants de type amphétamine : revue systématique et méta-analyse d'essais randomisés contrôlés par placebo.","authors":"Laurent Elkrief, Heidar Sharafi, Hamzah Bakouni, Christina McAnulty, Gabriel Bastien, Simon Dubreucq, Nicolas Garel, Annie Trépanier, Daniela Ziegler, Didier Jutras-Aswad","doi":"10.1177/07067437241262967","DOIUrl":"10.1177/07067437241262967","url":null,"abstract":"<p><strong>Introduction: </strong>Amphetamine-type stimulants (ATSs) are related to significant harm worldwide, with limited effective pharmacological treatments for ATS use disorder (ATSUD). Modafinil has been explored as a potential treatment for ATSUD. This systematic review and meta-analysis (PROSPERO ID: CRD42023388487) aimed to evaluate the efficacy and safety of modafinil for the treatment of ATSUD.</p><p><strong>Methods: </strong>A comprehensive search of major indexing sources and trial registries, from inception to search date, was conducted on February 15, 2023, and updated on October 31, 2023. Eligible studies were randomized placebo-controlled trials (RCTs) of modafinil in individuals meeting the criteria for the Diagnostic and Statistical Manual of Mental Disorders, fourth and fifth editions, diagnoses of ATSUD. Eligible studies were assessed for risk of bias, using the Cochrane Risk of Bias tool. The primary outcome included the effect of modafinil on ATS use. Secondary outcomes included retention in treatment, ATS craving, treatment discontinuation due to adverse events (AEs), and serious AEs. Subgroup analysis by modafinil dose was conducted where appropriate. Risk ratio (RR) or Peto's odds ratio (OR) was calculated for the meta-analysis of dichotomous variables and standardized mean difference (SMD) was calculated for the random-effect meta-analysis of continuous variables.</p><p><strong>Results: </strong>Five RCTs (<i>N</i> = 451 participants) were included. Modafinil did not significantly impact ATS use (RR = 0.99; 95% CI, 0.97 to 1.02; <i>p</i> = 0.655), retention in treatment (RR = 1.02; 95% CI, 0.91 to 1.14; <i>p</i> = 0.799), ATS craving (SMD = -0.36; 95% CI, -1.19 to 0.47; <i>p</i> = 0.398), or treatment discontinuation due to AEs (Peto's OR = 0.48; 95% CI, 0.20 to 1.14; <i>p</i> = 0.100). These results were consistent across subgroup analyses. More episodes of serious AEs were reported in the modafinil group than in the placebo group, at higher doses (Peto's OR = 4.80; 95% CI, 1.18 to 19.56, <i>p</i> = 0.029).</p><p><strong>Conclusion: </strong>There is currently no evidence suggesting that modafinil has a statistically significant effect on efficacy outcomes in populations with ATSUD. Continued research into effective treatments and harm reduction strategies for ATSUD is essential.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"793-805"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735727","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":"Eco-Depression and Eco-Anxiety Among Youth: A Sex and Gender Analysis.","authors":"Louisa L Y Man, Martin Rotenberg, Swelen Andari, Samantha Wells, Hayley A Hamilton, Angela Boak, Sean A Kidd","doi":"10.1177/07067437241287153","DOIUrl":"10.1177/07067437241287153","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"831-833"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332810","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":"Protective Factors for Mental Disorders Among Survivors of Military Sexual Trauma: A Canadian Population-Based Study: Facteurs de protection relatifs à l'apparition de troubles mentaux chez les survivantes et survivants de traumatismes sexuels liés au service militaire : une étude basée sur la population canadienne.","authors":"Jordana L Sommer, Shay-Lee Bolton, Renée El-Gabalawy, Tracie O Afifi, Jitender Sareen, Natalie Mota","doi":"10.1177/07067437241293977","DOIUrl":"10.1177/07067437241293977","url":null,"abstract":"<p><strong>Objectives: </strong>Military sexual trauma (MST) is a prevalent issue among actively serving members and Veterans, and is associated with adverse health outcomes including mental disorders. This study sought to identify correlates and protective factors for the development of mental disorders among Canadian MST survivors.</p><p><strong>Methods: </strong>We analyzed data from participants of the longitudinal 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) who experienced MST (rounded <i>n </i>= 455; 9.6%). A semi-structured diagnostic interview assessed MST and mental disorders in accordance with DSM-IV criteria. Multivariable logistic regressions examined associations between sample characteristics (2002 and 2018) and psychosocial factors (at baseline [i.e., 2002] and 2018) and any mental disorder since 2002. Analyses were run among the full subsample of MST survivors and additionally stratified by sex, when possible.</p><p><strong>Results: </strong>Among MST survivors, 66.5% had a mental disorder since 2002. Among the total sample, those who were officers (odds ratio [OR] = 0.58) or on active duty (OR = 0.52) had reduced odds of any mental disorder since 2002. In addition, less frequent use of avoidance coping in 2002 and 2018 (adjusted odds ratio [AOR]: 0.86, 0.64), more frequent use of active coping in 2018 (AOR = 0.64), less frequent use of self-medication coping in 2018 (AOR = 0.79), greater perceived social support in 2018 (AOR = 0.94), and reduced work stress across various domains in 2018 (AOR: 0.67-0.87) were associated with reduced odds of any mental disorder since 2002. Some variability emerged according to sex (e.g., types of work stress or coping emerging as protective).</p><p><strong>Conclusions: </strong>Results highlight certain sample characteristics and psychosocial factors that illustrated a protective relationship with mental disorders among MST survivors. Findings may inform targeted intervention strategies that could help mitigate adverse mental health impacts of MST.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"820-830"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607530","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":"Virtual Versus In-Person Follow-up After a Psychiatric Emergency Visit: A Population-Based Cohort Study: Suivi virtuel opposé à en personne après une visite à l'urgence psychiatrique : une étude de cohorte dans la population.","authors":"Matthew Crocker, Anjie Huang, Kinwah Fung, Therese A Stukel, Alene Toulany, Natasha Saunders, Paul Kurdyak, Lucy C Barker, Tanya S Hauck, Martin Rotenberg, Emily Hamovitch, Simone N Vigod","doi":"10.1177/07067437241281068","DOIUrl":"10.1177/07067437241281068","url":null,"abstract":"<p><strong>Objective: </strong>With increased utilization of virtual care in mental health, examining its appropriateness in various clinical scenarios is warranted. This study aimed to compare the risk of adverse psychiatric outcomes following virtual versus in-person mental health follow-up care after a psychiatric emergency department (ED) visit.</p><p><strong>Methods: </strong>Using population-based health administrative data in Ontario (2021), we identified 28,232 adults discharged from a psychiatric ED visit who had a follow-up mental health visit within 14 days postdischarge. We compared those whose first follow-up visit was virtual (telephone or video) versus in-person on their risk for experiencing either a repeat psychiatric ED visit, psychiatric hospitalization, intentional self-injury, or suicide in the 15-90 days post-ED visit. Cox proportional hazard models generated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs), adjusted for age, income quintile, psychiatric hospitalization, and intentional self-injury in the 2 years prior to ED visit. We stratified by sex and diagnosis at index ED visits based on the International Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD-10-CA) coding.</p><p><strong>Results: </strong>About 65% (<i>n</i> = 18,354) of first follow-up visits were virtual, while 35% (<i>n</i> = 9,878) were in-person. About 13.9% and 14.6% of the virtual and in-person groups, respectively, experienced the composite outcome, corresponding to incidence rates of 60.9 versus 74.2 per 1000 person-years (aHR 0.95, 95% CI 0.89 to 1.01). Results were similar for individual elements of the composite outcome, when stratifying by sex and index psychiatric diagnosis, when varying exposure (7 days) and outcome periods (60 and 30 days), and comparing \"only\" virtual versus \"any\" in-person follow-up during the 14-day follow-up.</p><p><strong>Conclusions and relevance: </strong>These results support virtual care as a modality to increase access to follow-up after an acute care psychiatric encounter across a wide range of diagnoses. Prospective trials to discern whether this is due to the comparable efficacy of virtual and in-person care, or due solely to appropriate patient selection may be warranted.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"809-819"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301447","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":"What Psychiatrists Should Know About Prescribed Safer Opioid Supply.","authors":"Anees Bahji, Marlon Danilewitz, Arushi Sachdev, Nickie Mathew, Wiplove Lamba, Reza Rafizadeh, Nitin Chopra, Arash Dhaliwal, Tony P George, David Crockford, Valerie Primeau, Philip Tibbo, Leslie Buckley, Robert Tanguay","doi":"10.1177/07067437241289964","DOIUrl":"10.1177/07067437241289964","url":null,"abstract":"<p><strong>Plain language summary title: </strong>What Psychiatrists Should Know About Prescribed Safer Opioid Supply.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"806-808"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481431","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":"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":"7067437241293984"},"PeriodicalIF":4.3,"publicationDate":"2024-10-29","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}

{"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":"7067437241290193"},"PeriodicalIF":4.3,"publicationDate":"2024-10-21","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}