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

{"title":"Distribution of Cytochrome P450 Metabolizer Status and Allelic Variants in Individuals with Mental Health Disorders in Ontario, Canada: Répartition du statut métabolique du cytochrome P450 et des variantes alléliques chez les personnes atteintes de problèmes de santé mentale en Ontario, au Canada.","authors":"Megana Thamilselvan, Alex J Coulter, Deanna Herbert, Anashe Shahmirian, Nicole King, Daniel J Müller, Arun Kumar Tiwari, Clement C Zai, James L Kennedy","doi":"10.1177/07067437261451952","DOIUrl":"10.1177/07067437261451952","url":null,"abstract":"<p><p>IntroductionDrug metabolism is primarily carried out by the cytochrome P450 (CYP) family of enzymes in the liver. Based on an individual's diplotype, they can be classified into poor (PM), intermediate (IM), normal (NM), rapid (RM) or ultrarapid (UM) metabolizers. Here, we show the distribution of allele frequency and metabolizer status across ancestries for <i>CYP2D6, CYP2C19, CYP2C9, CYP2B6, CYP3A4</i> and <i>CYP1A2</i> in a cohort from Ontario, Canada.MethodsPatients currently taking or starting a psychotropic drug (<i>N</i> = 8,280) were enrolled. Patients self-reported their ancestry, and DNA was analysed for the <i>CYP2D6, CYP2C19, CYP2C9, CYP2B6, CYP3A4</i> and <i>CYP1A2</i> genes using a commercial pharmacogenetic test and metabolizer status was assigned using ClinPGx as a reference.ResultsThe cohort was primarily of European ancestry (70%), followed by individuals with mixed ancestry (9.3%). The combined frequency of PMs and UMs, representing the extremes of enzyme activity, was highest for CYP2C19 and CYP2D6, with this frequency being approximately 8% for each enzyme. The frequency varied considerably by ancestry, with up to 24% of individuals of Caribbean descent being CYP2C19 PMs or UMs, for example, compared to only 7% among those of Latin, Central and South American ancestry. Of the entire sample, only 5.1% were NMs across all enzymes, meaning 94.9% of individuals had a non-NM status and would benefit from pharmacogenetic testing.ConclusionOverall, this study provides a useful reference for variations in the <i>CYP</i> family of genes in the population of Ontario, Canada.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"703-711"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158850","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":"Faecal Transplantation for Bipolar Disorder.","authors":"Gordon Parker","doi":"10.1177/07067437261445768","DOIUrl":"10.1177/07067437261445768","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"734-735"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789560","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":"Association Between Venlafaxine Exposure And Treatment Outcomes In Older Adults With Depression: Association entre l'exposition à la venlafaxine et les résultats du traitement chez les personnes âgées atteintes de dépression.","authors":"Xiaoyu Men, Zachary L Taylor, Victoria S Marshe, Daniel M Blumberger, Jordan F Karp, James L Kennedy, Cristiana Stefan, Laura B Ramsey, Eric J Lenze, Charles F Reynolds, Benoit H Mulsant, Daniel J Müller","doi":"10.1177/07067437261451057","DOIUrl":"10.1177/07067437261451057","url":null,"abstract":"<p><p>BackgroundVenlafaxine is commonly prescribed for older adults with depression, yet the relationship between venlafaxine-related exposure and treatment outcomes remains unclear. We aimed to assess the association of exposure to venlafaxine, its active metabolite O-desmethylvenlafaxine (ODV) and its active moiety (i.e., venlafaxine + ODV) with treatment response and adverse effects in late-life depression.MethodWe analyzed data from 325 participants from the Incomplete Response in Late-Life Depression: Getting to Remission (IRL-GRey) study. Participants were ≥ 60 years old, treated openly with venlafaxine (up to 300 mg/day) for 12 weeks. Treatment response was assessed with the Montgomery-Asberg Depression Rating Scale and adverse effects were evaluated with the Udvalg for Kliniske Undersøgelser (UKU) rating scale. Venlafaxine-related exposures were derived from a published population pharmacokinetic model based on the IRL-GRey study, and their associations with treatment outcomes were assessed using regression analyses.ResultAt week 4, the primary endpoint, higher venlafaxine-related exposures were not associated with greater symptom improvement. While at the end of treatment (week 12), we did not observe additional antidepressant benefit with increased venlafaxine-related exposures, higher ODV and active moiety exposures were associated with the occurrence of at least one adverse effect (odds ratio [OR] = 1.6 [1.1, 2.3], <i>p</i> = 0.02 and 1.8 [1.2, 2.6], <i>p</i> = 0.003, respectively). Also, higher venlafaxine and active moiety exposures were associated with nausea/vomiting (OR = 1.1 [1.0, 1.2], <i>p</i> = 0.02 and 2.3 [1.3, 4.0], <i>p</i> = 0.006); while higher active moiety exposure was associated with orthostatic dizziness (OR = 1.9 [1.1, 3.2], <i>p</i> = 0.02).ConclusionOur findings suggest a potential threshold effect, where venlafaxine-related exposure past a certain level did not enhance antidepressant response but increased adverse-effect burden. These results support incorporating exposure measures from therapeutic drug monitoring in antidepressant studies to address the heterogeneity of safety and tolerability outcomes.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"691-702"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13176123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935493","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":"Oral Methods of Microbiota Manipulation for Depression Symptoms: A Systematic Review: Méthodes orales de manipulation du microbiote pour traiter les symptômes de dépression : Une revue systématique.","authors":"Anna Oprea, Joe Steinman, Grace Huang, Omolara Soyinka, Megan Brookbank, James Abesteh, Maya Hartman, Alannah McEvoy, Joanna C Dionne, Roumen Milev, Zainab Samaan","doi":"10.1177/07067437251394369","DOIUrl":"10.1177/07067437251394369","url":null,"abstract":"<p><p>ObjectiveThe effectiveness of current treatment options for depressive symptoms has been widely investigated with acknowledgment that some patients were either not adequately responding to treatment, finding the existing treatment intolerable, or otherwise prefer alternative options. There is increasing interest in microbiota modulation as an alternate form of depression treatment, with a growing number of trials and reviews on the subject published in the last five years. This systematic review aimed to analyze all completed randomized control trials (RCTs) that assessed depression symptoms in adults not using antidepressants, before and after oral methods of microbiota manipulation.MethodAll completed parallel-arm RCTs that assessed depression symptoms in adult participants before and after oral methods of microbiota manipulation were retrieved from four databases, MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled Trials. Data on study and intervention characteristics as well as RCT conclusions were collected independently and in duplicate, and each study's findings were summarized individually. Risk of bias was completed.ResultsWe included 66 RCTs in our review, 34 of which concluded significant differences between the intervention and control group in depressive symptom using different interventions and measures. Of the 66 trials, 54 used probiotic interventions, seven used prebiotic, eight used synbiotic and two used oral fecal microbiota transplantation. Wide variation was observed in studies' design, intervention composition and consumption methods across all 66 RCTs. No statistical synthesis or meta-analyses were possible due to the wide variety of interventions, measures and outcomes.ConclusionsThe heterogeneity of the existing RCTs did not allow for concrete conclusions on whether oral microbiota manipulation interventions are viable alternative treatment options for adults experiencing depression symptoms. We encourage the development of standardized guidelines for the design and reporting of microbiota studies in depression for the possibility of future intervention efficacy testing.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"663-672"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642735","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 Safety, Efficacy, and Feasibility of Fecal Microbiota Transplantation in a Population With Bipolar Disorder During Depressive Episodes: A Pilot Parallel Arm Randomized Controlled Trial: Sécurité, efficacité et faisabilité de la transplantation de microbiote fécal chez une population atteinte de troubles bipolaires, au cours d'épisodes dépressifs : essai pilote contrôlé à répartition aléatoire et à groupes parallèles.","authors":"Shahrokh Shekarriz, Simone N Vigod, Teresa Bianco, Asem Bala, Chenhui Hao, Johane P Allard, Susy Hota, Susan Poutanen, Michael G Surette, Valerie H Taylor","doi":"10.1177/07067437261420877","DOIUrl":"10.1177/07067437261420877","url":null,"abstract":"<p><p>BackgroundThe gut microbiome has been proposed as a potential modifiable target to treat mental illness. This double-blind randomized control trial investigated fecal microbiota transplant (FMT) in bipolar disorder (BD) to assess efficacy, safety, and feasibility. The primary outcome evaluated the effectiveness of standard approved therapy for BD depression + FMT in individuals not responding to standard treatment, measured by change in the Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to week 24. Secondary outcomes included FMT's impact on anxiety, global function, side-effects, and safety. The feasibility of this novel intervention was also assessed. Microbial analysis utilized whole-genome shotgun metagenomic sequencing, comparing outcomes between allogenic (donor) and autologous (participants own) FMT.MethodsA total of 35 participants (28 women and 7 men) with at least moderate depressive-phase BD (MADRS) were randomized to receive either allogenic FMT (n = 17) or autologous FMT (n = 18) via colonoscopy and were followed for 24 weeks.ResultsMADRS scores significantly improved from baseline to the last visit in both treatment arms. There was no significant difference between allogenic FMT (16.74-point improvement) and autologous FMT (15.4-point improvement) regarding clinical efficacy (t = -0.47, p-value = .64, 95% confidence interval [CI] = -7.3-4.6). Microbiota analysis showed that allogenic FMT let to a bacterial profile similar to the healthy donor and increased bacterial diversity at the 6-month mark, whereas those receiving autologous FMT did not. The intervention was well tolerated with no significant adverse events. Recruitment, randomization, and retention metrics support feasibility of a larger trial.ConclusionFeasibility and tolerability data indicate further investigation into microbial manipulation in BD is warranted. The absence of efficacy differences between the two types of FMT, despite microbial change, highlights the importance of a true placebo in future studies, as well as the importance of understanding exactly what bacteria are linked to improvements. ClinicalTrials.gov, NCT0327922Plain Language Summary TitleResults of a Double-Blind Randomized Control Trial Investigating Fecal Microbiota Transplant (FMT) as an Add-on Treatment for Depression in Bipolar Disorder and Analyzing Microbial Diversity Changes Over 24 Weeks.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"675-690"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367195","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":"Effectiveness of Recovery Colleges: A Nonrandomised Clinical Trial Across Two Years Using Propensity Score Matching: Efficacité des collèges de rétablissement: essai clinique non randomisé sur deux ans utilisant l'appariement par score de propension.","authors":"Marloes M C van Wezel, Robin L A Smits, Christien Muusse, Ben F M Wijnen, Dike van de Mheen, Mike Slade, Claire Henderson, Hans Kroon","doi":"10.1177/07067437261449914","DOIUrl":"10.1177/07067437261449914","url":null,"abstract":"<p><p>BackgroundRecovery colleges (RCs) facilitate peer-supported communities where people with lived experience of mental disruption learn collaboratively, aiming to foster empowerment and personal recovery. While existing (qualitative) research relates RC attendance to positive outcomes, high-quality multi-college quantitative studies evaluating RC effectiveness are scarce.AimsWe examine the extent to which RC attendance impacts empowerment (primary outcome) and other recovery-related outcomes.MethodIn this nonrandomised clinical trial (May 2022 to January 2025), RC partakers from four Dutch RCs were compared with controls over 2 years, in annual data collections. Linear mixed model analyses were conducted to investigate interactions between group and time. Exploratory analyses investigated distinguishing characteristics of RC partakers. This study was embedded in a larger project and was pre-registered (clinicaltrials.gov: #NCT05620212). Academic and experiential researchers collaborated in the design, recruitment, and analysis.ResultsThe sample comprised 91 RC partakers and 182 matched controls. RC partakers faced severe or persistent mental health challenges and attended RCs in multiple capacities (e.g., student and visitor/volunteer). Outcomes were mostly stable over time and did not differ between groups. Hence, no group-specific changes over time were found, as shown by interaction terms that were not statistically significant (e.g., empowerment: <i>estimate T1*RC=</i> 0.02, <i>95% CI=</i> -0.08-0.13, <i>estimate T2*RC=</i> -0.001, <i>95% CI=</i> -0.11-0.11).ConclusionsDespite promising qualitative evidence of RC effectiveness, our study found no differences between RC partakers and matched controls in quantitative recovery-related outcomes over time. Factors of influence may be possible pre-study effects, unmeasured confounding, or limitations in how standardised questionnaires capture recovery experiences. Methodologically, the findings raise questions about the operationalisation of effectiveness in the context of personal recovery and flexible, co-created practices such as RCs. Importantly, while this study could not establish <i>measurable</i> effectiveness, this does not automatically imply that RC attendance cannot <i>meaningfully</i> contribute to recovery.Plain Language Summary TitleStudy evaluating if recovery colleges have effects on recovery by comparing survey scores of people who do vs. do not attend them across two years.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"712-733"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13176122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943641","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":"Faecal Transplants for Bipolar Depression: Moving out of the Periphery?","authors":"Timothy G Dinan, John F Cryan","doi":"10.1177/07067437261428007","DOIUrl":"10.1177/07067437261428007","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"673-674"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367226","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":"Investigating Whether Summarizing Raw Clinical Text Affects the Prediction of In-Hospital Violence: A Retrospective Case Study: Évaluation de l'effet du résumé des textes cliniques bruts sur la prédiction de la violence en milieu hospitalier : étude de cas rétrospective.","authors":"Zixuan Yu, Jacqueline Chipkin, Julia Siar, Suelynn Emily Ren, Fei Xia, Meliha Yetisgen, Nicholas J Dobbins, Taylor M Black","doi":"10.1177/07067437261479118","DOIUrl":"10.1177/07067437261479118","url":null,"abstract":"<p><p>BackgroundWe evaluated whether summaries and large language models (LLMs) preserve predictive performance for inpatient violence risk and assessed performance across demographics.MethodsWe conducted a retrospective study of inpatient encounters at Harborview Medical Center between March 2021 and September 2023. Cases were inpatient behavioural violence events, and each was matched to 10 control encounters. For each encounter, we used clinical notes from the 72 hours before the event for cases and a matched window for controls. We compared Clinical-Longformer trained on original notes with pipelines that first generated summaries and then classified risk. Summaries were either general or guided by clinician-defined risk entities. We also tested Llama-3.1-8B and MedGemma-27B in zero-shot (ZS) and fine-tuned settings. Primary endpoints were positive-class precision, recall, and F1. We also reported overall and subgroup area under the receiver operating characteristic curve (AUROC) with bootstrap confidence intervals for sex, race, ethnicity, age, and mental health flag.ResultsClinical-Longformer on original notes achieved the strongest performance (F1 = 0.776, AUROC = 0.959). Replacing original notes with general or entity-guided summaries reduced performance (F1 = 0.465 and 0.510). Llama-3.1-8B improved with sequence-classification fine-tuning on original notes but remained below Clinical-Longformer (F1 = 0.701; AUROC = 0.933), while ZS prompting performed poorly. MedGemma-27B also remained inferior, with its best performance from sequence-classification fine-tuning on original notes (F1 = 0.612, AUROC = 0.947). Subgroup AUROCs were high across sex, race, ethnicity, and age, with lower performance among patients with a documented mental health flag.ConclusionDirect classification of original notes remained the most reliable strategy. Summaries of clinical notes may compress or alter cues needed for discrimination, and off-the-shelf prompting was inadequate as a stand-alone predictor. A practical path is to anchor risk scoring in long-context discriminative models and use LLMs for auditable, clinician-facing summaries or rationales. Prospective and external validation are needed before clinical deployment.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261479118"},"PeriodicalIF":4.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867903","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":"In Memoriam: Lili C. Kopala, MD, FRCPC (1946-2026).","authors":"William G Honer","doi":"10.1177/07067437261483430","DOIUrl":"https://doi.org/10.1177/07067437261483430","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261483430"},"PeriodicalIF":4.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Addiction Treatment Engagement: A Canadian Randomized Effectiveness Trial of Remotely Administered Contingency Management for Treatment Attendance: Cibler l'engagement en matière de traitement des dépendances : essai d'efficacité à répartition aléatoire mené au Canada portant sur la gestion des contingences mise en œuvre à distance pour la participation au traitement.","authors":"David C Hodgins, Jane Yi, Angela Wallace, Laurence Macrae Lynch, Ashley Ethier, Luija Long, Megan E Cowie","doi":"10.1177/07067437261477550","DOIUrl":"10.1177/07067437261477550","url":null,"abstract":"<p><p>IntroductionContingency management (CM) is an evidence-based treatment used as a stand-alone treatment or an adjunct to usual care for individuals with substance use disorders (SUDs). However, its use in clinical practice is limited, particularly in Canada. This study implemented and evaluated the effectiveness of CM for SUDs in 2 outpatient addiction clinics in Alberta.MethodsA 3-month, 2-armed, parallel-group, unblinded intervention comparing attendance-based CM (<i>n</i> <i>=</i> 43) with a treatment-as-usual (TAU) control group (<i>n</i> = 45). Participants in the CM group were incentivized using a hybrid prize-and-voucher method. Specifically, treatment attendance was rewarded with virtual prize draws, the number of which accrued incrementally based on consecutive attendance.ResultsParticipants in CM were retained in treatment for longer durations and attended more treatment sessions with greater consistency compared to participants in TAU. No differences between groups were observed for substance use outcomes or quality of life. The small sample size limits the generalizability of the results.ConclusionOur results support the adaptability of CM in the Canadian context to improve treatment retention and attendance. The remote capabilities of CM reduce the barriers to access, allowing for greater reach of this intervention. The results highlight how CM can be tailored to be more economical through its focus on attendance, a focus consistent with improving addiction recovery in Canada.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261477550"},"PeriodicalIF":4.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842389","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}