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

{"title":"Computer-Based Training for Cognitive Behavioural Therapy for Substance Use Disorder: A Randomized Controlled Trial Including Quantitative and Qualitative Health and Economic Outcomes: Formation informatisée pour la thérapie cognitivo-comportementale pour les troubles liés à l'usage de substances : un essai randomisé contrôlé y compris les résultats quantitatifs et qualitatifs en matière de santé et d'économie.","authors":"Alina Patel, Michael Corman, Claire de Oliveira, Joyce Mason, Nibene Somé, Danielle Downie, Esha Jain, Michelle Patterson, John A Cunningham, Tony P George, Bernard Le Foll, Lena C Quilty","doi":"10.1177/07067437241255100","DOIUrl":"10.1177/07067437241255100","url":null,"abstract":"<p><strong>Objectives: </strong>Heavy alcohol and drug use is reported by a substantial number of Canadians; yet, only a minority of those experiencing substance use difficulties access specialized services. Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT) offers a low-cost method to deliver accessible and high-quality CBT for substance use difficulties. To date, CBT4CBT has primarily been evaluated in terms of quantitative outcomes within substance use disorder (SUD) samples in the United States. A comparison between CBT4CBT versus standard care for SUDs in a Canadian sample is critical to evaluate its potential for health services in Canada. We conducted a randomized controlled trial of CBT4CBT versus standard care for SUD.</p><p><strong>Methods: </strong>Adults seeking outpatient treatment for SUD (<i>N</i> = 50) were randomly assigned to receive either CBT4CBT or treatment-as-usual (TAU) for 8 weeks. Measures of substance use and associated harms and quality of life were completed before and after treatment and at 6-month follow-up. Qualitative interviews were administered after treatment and at follow-up, and healthcare utilization and costs were extracted for the entire study period.</p><p><strong>Results: </strong>Participants exhibited improvements on the primary outcome as well as several secondary outcomes; however, there were no differences between groups. A cost-effectiveness analysis found lower healthcare costs in CBT4CBT versus TAU in a subsample analysis, but more days of substance use in CBT4CBT. Qualitative analyses highlighted the benefits and challenges of CBT4CBT.</p><p><strong>Discussion: </strong>Findings supported an overall improvement in clinical outcomes. Further investigation is warranted to identify opportunities for implementation of CBT4CBT in tertiary care settings.<b>Trial Registration:</b> https://clinicaltrials.gov/ct2/show/NCT03767907.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"9-20"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089466","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":"Prenatal Cannabis and Tobacco Co-Exposure and Its Association with Behavioural Outcomes in Middle Childhood: Co-exposition prénatale au cannabis et au tabac et son association avec les résultats comportementaux au cours de l'enfance intermédiaire.","authors":"Emma Nadler, Joanna Jacobus, Rachel A Rabin","doi":"10.1177/07067437241271696","DOIUrl":"10.1177/07067437241271696","url":null,"abstract":"<p><strong>Objectives: </strong>Cannabis legalization has triggered an increase in prenatal cannabis use. Given that tobacco is commonly co-used with cannabis, determining outcomes associated with prenatal cannabis and tobacco co-exposure is crucial. While literature exists regarding the individual effects of prenatal cannabis and tobacco exposure on childhood behaviour, there is a gap regarding their combined use, which may have interactive effects. Therefore, we investigated whether prenatal cannabis and tobacco co-exposure was associated with greater externalizing and internalizing problems in middle childhood compared to prenatal exposure to either substance alone or no exposure.</p><p><strong>Methods: </strong>Baseline data from the Adolescent Brain Cognitive Development (ABCD) Study (collected in children ages 9-11) were used to explore differences in externalizing and internalizing scores derived from the Childhood Behavior Checklist across four groups: children with prenatal cannabis and tobacco co-exposure (CT, <i>n</i> = 290), children with prenatal cannabis-only exposure (CAN, <i>n</i> = 225), children with prenatal tobacco-only exposure (TOB, <i>n</i> = 966), and unexposed children (CTL, <i>n</i> = 8,311). We also examined if the daily quantity of tobacco exposure modulated the effect of cannabis exposure on outcomes.</p><p><strong>Results: </strong>Adjusting for covariates, a 2 × 2 ANCOVA revealed significant main effects for prenatal cannabis (<i>p</i> = 0.03) and tobacco exposure (<i>p</i> < 0.001), and a significant interaction effect on externalizing scores (<i>p</i> = 0.032); no significant main effects or interactions were found for internalizing scores. However, interactions between daily quantity of cannabis and tobacco exposure significantly predicted both externalizing and internalizing scores (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>These findings indicate that co-exposure is associated with greater externalizing problems than exposure to either substance alone, which did not differ from each other. Further, greater tobacco exposure may amplify the negative effect of cannabis exposure on both externalizing and internalizing behaviours in children. These findings underscore the need for interventions that target cannabis and tobacco co-use in pregnant women to circumvent their adverse impact on middle childhood behaviour.</p><p><strong>Plain language summary title: </strong>Prenatal Cannabis and Tobacco Co-exposure and its Association with Middle Childhood Behaviours.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"41-53"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977323","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":"Substance Use and Concurrent Disorders: Current Context and the Need for Treatment Integration.","authors":"Christian S Hendershot, Bernard Le Foll","doi":"10.1177/07067437241305174","DOIUrl":"10.1177/07067437241305174","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"5-8"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803420","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":"Effects of Trauma Cue Exposure and Posttraumatic Stress Disorder (PTSD) on Affect and Cannabis Craving in Cannabis Users With Trauma Histories: Use of Expressive Writing as an Online Cue-Reactivity Paradigm: Effets de l'exposition aux signaux traumatiques et du SSPT sur l'affect et le besoin de cannabis chez les consommateurs de cannabis ayant des antécédents de traumatismes : utilisation de l'écriture expressive comme paradigme de réactivité en ligne.","authors":"Sarah DeGrace, Sean P Barrett, Igor Yakovenko, Philip G Tibbo, Pablo Romero-Sanchiz, R Nicholas Carleton, Thomas Snooks, Abraham Rudnick, Sherry H Stewart","doi":"10.1177/07067437241255104","DOIUrl":"10.1177/07067437241255104","url":null,"abstract":"<p><strong>Objectives: </strong>Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) commonly co-occur. Conditioned associations between psychological trauma cues, distress, cannabis use, and desired relief outcomes may contribute to the comorbidity. These conditioned associations can be studied experimentally by manipulating trauma cue exposure in a cue-reactivity paradigm (CRP) and examining effects on affective and cognitive outcomes in participants with and without PTSD. However, traditional CRPs take place in-lab limiting recruitment/power. We aimed to examine the effects of CRP condition (trauma and neutral) and PTSD group (likely PTSD+ and PTSD-) on affective and craving outcomes using a stand-alone online expressive writing CRP.</p><p><strong>Methods: </strong>Participants (<i>n </i>= 202; 43.6% male; <i>M</i>_age = 42.94 years, <i>SD </i>= 14.71) with psychological trauma histories and past-month cannabis use completed a measure of PTSD symptoms (PTSD Checklist-5 for DSM-5 [PCL-5]) and were randomized to complete either a trauma or neutral expressive writing task. Then they completed validated measures of affect (Positive and Negative Affect Schedule-Short Form [PANAS-SF]) and cannabis craving (Marijuana Craving Questionnaire-Short Form [MCQ-SF]).</p><p><strong>Results: </strong>Linear mixed models tested the hypothesized main and interactive effects of CRP condition (trauma and neutral) and PTSD group (likely PTSD+ and PTSD-) on negative and positive affect (PANAS-SF) and cannabis craving dimensions (MCQ-SF). The hypothesized main effects of trauma versus neutral expressive writing were found for negative affect and the expectancy dimension of cannabis craving and of PTSD group for negative affect and all cannabis craving dimensions; no interactions were observed.</p><p><strong>Conclusions: </strong>Expressive writing appears a useful online CRP. Interventions focused on reducing negative affect and expectancy craving to trauma cues may prevent/treat CUD among cannabis users with PTSD.</p><p><strong>Plain language summary title: </strong>The Use of an Online Expressive Writing as a Trauma Cue Exposure: Effects on Craving and Emotions.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"54-64"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946598","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":"Role of Momentary Alcohol Cognitions in Event-Level Relations Between PTSD Symptoms and Alcohol Outcomes: Le rôle des cognitions momentanées liées à l'alcool au niveau de l'événement entre les symptômes du TSPT et la consommation d'alcool.","authors":"Michelle J Zaso, Craig R Colder, Lucia M Fetkenhour, Jennifer P Read","doi":"10.1177/07067437241300082","DOIUrl":"10.1177/07067437241300082","url":null,"abstract":"<p><strong>Objective: </strong>Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur. Momentary alcohol cognitions may represent in-the-moment, modifiable risk factors to target in interventions for comorbid PTSD and AUD. However, the role of such cognitions in risk for problematic drinking as it emerges in response to individuals' fluctuating PTSD symptoms across their daily lives remains unknown. The present study aimed to test whether state-level PTSD-alcohol expectancies and/or drinking motives modulate in-the-moment associations between PTSD symptoms and alcohol outcomes.</p><p><strong>Method: </strong>Frequent drinking adults with current PTSD (<i>n </i>= 54) reported on their posttraumatic symptoms and alcohol cognitions, craving, and consumption during four momentary surveys each day for 14 days (3,024 observations) in an ecological momentary assessment design. Multilevel moderation analyses tested whether in-the-moment PTSD-alcohol expectancies and/or drinking motives moderated relations of PTSD symptoms with alcohol craving and consumption.</p><p><strong>Results: </strong>Findings demonstrated a significant interaction between PTSD symptoms and coping drinking motives on in-the-moment alcohol craving. Specifically, greater experience of PTSD symptoms related more strongly to craving for alcohol during events in which drinkers endorsed higher levels of coping drinking motives. There were no additional interaction effects for drinking motives or PTSD-alcohol expectancies on either alcohol craving or consumption.</p><p><strong>Conclusions: </strong>Coping drinking motives appear to convey strong in-the-moment risk for PTSD-related alcohol craving yet not subsequent alcohol consumption. Future research should delineate concurrent alcohol risk and possible protective processes active in the presence of PTSD symptoms to help identify targets for interventions tailored to the unique risk processes maintaining comorbid PTSD and AUD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"32-40"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803506","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 Implementation of Integrated Youth Services in Canada: Planning and Costing of a Pan-Canadian Model: La mise en œuvre des services intégrés pour les jeunes au Canada : planification et établissement des coûts d'un modèle pancanadien.","authors":"Jo L Henderson, Claire de Oliveira, Steve Mathias","doi":"10.1177/07067437241301008","DOIUrl":"10.1177/07067437241301008","url":null,"abstract":"<p><strong>Objective: </strong>The implementation of Integrated Youth Services (IYS) can help ensure that youth are adequately supported. The objective of this analysis was to provide a model for the planning and costing of IYS throughout Canada over a 15-year period.</p><p><strong>Methods: </strong>To estimate resource allocation for IYS, we determined the number of hubs and hub staffing requirements by service level and jurisdiction, backbone support and infrastructure requirements by jurisdiction. A needs-based analytic framework for planning was employed to estimate the number of hubs required. The optimal mix of hub staffing requirements was determined based on prior literature. The costs of running each hub were estimated using publicly available data and internal documents from existing IYS agencies. Finally, the cost of setting up IYS hubs, IYS virtual care and respective backbone support throughout Canada was estimated and projected over 15 years and the cost-savings of IYS were calculated.</p><p><strong>Results: </strong>At maturity, it was estimated that 399 hubs-188 small, 43 medium, 168 large-across Canada would be required to address youth mental health and substance use needs. The cost of implementing IYS initiatives across Canada would vary between $4,349,126 (for less populous jurisdictions) and $248,950,524 (for more populous jurisdictions), for a total annual cost of $676,633,388 (excluding costs of infrastructure). It was estimated that the implementation of IYS hubs would lead to cost-savings of $2.1 billion annually and have the potential to be cost-effective.</p><p><strong>Conclusion: </strong>The implementation of IYS hubs can provide good value for money, in the form of high client satisfaction, earlier supports with improved youth outcomes and decreased health care costs. Future work should address gaps in data availability on mental health and substance use-related needs of youth with neurodevelopmental disorders, youth experiencing homelessness, youth in congregate living and foster care, and Indigenous youth.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241301008"},"PeriodicalIF":3.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803423","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":"Rethinking Schizophrenia-A Manageable Chronic Condition.","authors":"Robert B Zipursky","doi":"10.1177/07067437241301572","DOIUrl":"10.1177/07067437241301572","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241301572"},"PeriodicalIF":3.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803504","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":"Magnetic Seizure Therapy in Refractory Psychiatric Disorders: A Systematic Review and Meta-Analysis: La thérapie par convulsions magnétiques pour la prise en charge des troubles psychiatriques réfractaires : revue systématique et méta-analyse.","authors":"Jake Prillo, Lorina Zapf, Caroline W Espinola, Zafiris J Daskalakis, Daniel M Blumberger","doi":"10.1177/07067437241301005","DOIUrl":"10.1177/07067437241301005","url":null,"abstract":"<p><strong>Objective: </strong>To qualitatively and quantitatively synthesize the literature on the efficacy and safety of magnetic seizure therapy (MST) in psychiatric disorders.</p><p><strong>Methods: </strong>A literature search was conducted of the OVID Medline, OVID EMBASE, PsychINFO, CINAHL, Web of Science and Cochrane databases from inception to 14 January 2024, using subject headings and key words for \"magnetic seizure therapy.\" Randomized controlled trials (RCTs), post-hoc analyses of RCTs, open-label trials, or case series investigating MST in adults with a verified psychiatric diagnosis and reporting on two possible primary outcomes (1) psychiatric symptom reduction (as measured by validated rating scale) or (2) neurocognitive outcomes (as measured by standardized testing), were included. Abstracts, individual case reports, reviews and editorials were excluded. Extracted data included: (1) basic study details; (2) study design; (3) sample size; (4) baseline demographics; (5) outcome data (including secondary outcomes of suicidal ideation and adverse events); and (6) stimulation parameters. Cochrane's risk of bias tool was applied. A quantitative analysis was conducted for the depression studies, using Hedge's g effect sizes.</p><p><strong>Results: </strong>A total of 24 studies (n = 377) were eligible for inclusion. Seventeen studies in depression (including three RCTs), four studies in schizophrenia (including one RCT), one study in bipolar disorder, one study in obsessive-compulsive disorder and one study in borderline personality disorder were summarized. We found no significant difference in depressive symptom reduction between MST and electroconvulsive therapy (ECT) in randomized, controlled trials (g = 0.207 towards ECT, 95% confidence interval (CI) -0.132 to 0.545, <i>P</i> = 0.232). We found a significant reduction in depressive symptoms overall with MST in the pooled RCT and open-label analysis (g = 1.749, CI 1.219 to 2.279, <i>P</i> < 0.005). It is suggested that MST has modest cognitive side effects.</p><p><strong>Conclusions: </strong>Large-scale RCTs are necessary to confirm early signals of MST as an effective intervention in psychiatric disorders with a cognitive profile that is potentially more favourable than ECT.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241301005"},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Treatment of Schizophrenia in Adults With a 22q11.2 Microdeletion: Traitement dans le monde réel de la schizophrénie chez des adultes atteints du syndrome de microdélétion 22q11.2.","authors":"Lily Van, Tracy Heung, Nikolai Gil D Reyes, Erik Boot, Eva W C Chow, Maria Corral, Anne S Bassett","doi":"10.1177/07067437241293983","DOIUrl":"10.1177/07067437241293983","url":null,"abstract":"<p><strong>Objective: </strong>One in every 4 individuals born with a 22q11.2 microdeletion will develop schizophrenia. Thirty years of clinical genetic testing capability have enabled detection of this major molecular susceptibility for psychotic illness. However, there is limited literature on the treatment of schizophrenia in individuals with a 22q11.2 microdeletion, particularly regarding the issue of treatment resistance.</p><p><strong>Methods: </strong>From a large, well-characterized adult cohort with a typical 22q11.2 microdeletion followed for up to 25 years at a specialty clinic, we studied all 107 adults (49 females, 45.8%) meeting the criteria for schizophrenia or schizoaffective disorder. We performed a comprehensive review of lifetime (1,801 patient-years) psychiatric records to determine treatments used and the prevalence of treatment-resistant schizophrenia (TRS). We used Clinical Global Impression-Improvement (CGI-I) scores to compare within-individual responses to clozapine and nonclozapine antipsychotics. For a subgroup with contemporary data (<i>n</i> = 88, 82.2%), we examined antipsychotics and dosage at the last follow-up.</p><p><strong>Results: </strong>Lifetime treatments involved on average 4 different antipsychotic medications per individual. Sixty-three (58.9%) individuals met the study criteria for TRS, a significantly greater proportion than for a community-based comparison (42.9%; χ² = 10.38, df = 1, <i>p </i>< 0.01). The non-TRS group was enriched for individuals with genetic diagnosis before schizophrenia diagnosis. Within-person treatment response in TRS was significantly better for clozapine than for nonclozapine antipsychotics (<i>p </i>< 0.0001). At the last follow-up, clozapine was the most common antipsychotic prescribed, followed by olanzapine, risperidone, and paliperidone. Total antipsychotic chlorpromazine equivalent dosages were in typical clinical ranges (median: 450 mg; interquartile range: 300, 750 mg).</p><p><strong>Conclusion: </strong>The results for this large sample indicate that patients with 22q11.2 microdeletion have an increased propensity to treatment resistance. The findings provide evidence about how genetic diagnosis can inform clinical psychiatric management and could help reduce treatment delays. Further research is needed to shed light on the pathophysiology of antipsychotic response and on strategies to optimize outcomes.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241293983"},"PeriodicalIF":3.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787766","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>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241300958"},"PeriodicalIF":3.3,"publicationDate":"2024-12-04","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}