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

{"title":"Enhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project: Améliorer les programmes de traitement intégré pour les troubles mentaux et les troubles liés à l'usage de substances psychoactives graves et concomitants : aperçu de la problématique des surdoses dans le cadre du projet ROAR CANADA.","authors":"Christian G Schütz, Tonia Nicholls, Laura Schmid, Sydney Penner, Myra Massey, Karina A Thiessen, Stefanie Todesco, Reza Rafizadeh, Kiefer Cowie, Sabrina K Syan, James MacKillop","doi":"10.1177/07067437251315516","DOIUrl":"10.1177/07067437251315516","url":null,"abstract":"<p><p>ObjectiveThis paper summarizes methods and initial overdose-related results from the Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction (ROAR CANADA) project. ROAR CANADA is a longitudinal observational study of individuals with severe concurrent substance use and mental disorders (also called dual disorders or dual diagnosis). The study sampled patients treated at two tertiary treatment centres in British Columbia, Red Fish Healing Centre and Heartwood Centre, along with a concurrent treatment unit at St. Joseph's in Ontario. These facilities have implemented evidence-based integrated treatment programs. Our first analysis explores selected baseline characteristics as potential risk factors for drug overdose in this population.MethodSociodemographic factors, trauma history, and impulsivity were part of a more comprehensive longitudinal assessment. In this first investigation, we use bivariate analysis and logistic and linear regression modelling to examine these variables in relation to overdose history.ResultsOverall, 291 of 450 participants (64.7%) reported a history of ≥1 overdose. Across the three centres, patients had a lifetime average of 7.6 (<i>SD</i> = 12.9) overdoses. The prevalence and mean number of overdoses were somewhat higher among Red Fish patients (74.5% and 8.5, respectively). Adverse childhood events, lifetime trauma history, and impulsivity were all high, but only lifetime trauma history emerged as significantly associated with overdose across all treatment centres. Impulsivity indicators were selectively associated with overdose by site, but not consistently within the overall sample.ConclusionsThese results highlight the importance of prioritizing trauma-informed care in the treatment of individuals with severe concurrent substance use and mental disorders, who are at high risk of overdose. The integration of trauma treatment into existing programs may enhance patient outcomes and contribute to the ongoing evolution of effective care strategies for this complex population. These findings are particularly relevant in light of the overdose crisis.Plain Language Summary TitleEnhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"600-610"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124218","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":"WITHDRAWAL - Administrative Duplicate Publication: Substance Use and Concurrent Disorders: Current Context and the Need for Treatment Integration.","authors":"","doi":"10.1177/07067437251318522","DOIUrl":"10.1177/07067437251318522","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"653"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470009","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":"A Matching-Adjusted Indirect Comparison (MAIC) of Centanafadine versus Methylphenidate Hydrochloride in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Short-Term Safety and Efficacy Outcomes: Comparaison indirecte ajustée par appariement (MAIC) entre centanafadine et le chlorhydrate de méthylphénidate chez les adultes atteints d'un trouble déficitaire de l'attention avec ou sans hyperactivité (TDAH) : Résultats en matière d'innocuité et d'efficacité à court terme.","authors":"Jeff Schein, Maryaline Catillon, Chunyi Xu, Alice Qu, Anaïs Lemyre, Marjolaine Gauthier-Loiselle, Martin Cloutier, Ann Childress","doi":"10.1177/07067437251342279","DOIUrl":"10.1177/07067437251342279","url":null,"abstract":"<p><p>ObjectivesTo compare the short-term safety and efficacy of centanafadine, an investigational treatment, versus long-acting controlled-release methylphenidate hydrochloride (methylphenidate, Foquest^®) among adult patients with attention-deficit/hyperactivity disorder (ADHD), using matching-adjusted indirect comparison (MAIC).MethodsThis anchored MAIC used pooled individual patient data (IPD) from two centanafadine trials (NCT03605680, NCT03605836) and published aggregate data from one methylphenidate trial (NCT02139124). Using propensity scores, IPD from the centanafadine trials were reweighted to match the aggregate baseline characteristics of the methylphenidate trial. Safety and efficacy outcomes were compared at Week 4. Safety outcomes were the rates of adverse events reported by ≥5% of patients in any treatment group in either trial with an incidence twice that of the placebo. The efficacy outcome was the mean change from baseline in Adult ADHD Investigator Symptom Rating Scale (AISRS)/ADHD Rating Scale-5 (ADHD-RS-5) score at Week 4.ResultsAfter matching, no significant differences in baseline characteristics were observed across trials. Relative to methylphenidate, centanafadine exhibited a better safety profile, with a significantly lower risk of insomnia (risk difference in percentage points: -9.46 points) and initial insomnia (-4.68 points). There was no significant difference in efficacy across treatments as measured by the mean change from baseline in AISRS/ADHD-RS-5 score.ConclusionsIn this MAIC, centanafadine was associated with a lower risk of insomnia and comparable (i.e., nondifferent) efficacy compared to methylphenidate at Week 4. Information on the comparative safety and efficacy of ADHD treatments in the adult population will help inform personalized treatment decisions given the range of treatment options with varying attributes.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"629-638"},"PeriodicalIF":3.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200904","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":"Involuntary Treatment for Severe Substance Use Disorders - Issues, Evidence and Considerations for its Use.","authors":"Benedikt Fischer, Wayne Hall, Didier Jutras-Aswad, Bernard Le Foll","doi":"10.1177/07067437251338553","DOIUrl":"10.1177/07067437251338553","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"597-599"},"PeriodicalIF":3.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041281","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":"Mental Health Service Type Use and Depressive Symptoms: A Multivariable Analysis of Sociodemographic Correlates: Utilisation des services de santé mentale et symptômes dépressifs : Analyse multi-variables des corrélats sociodémographiques.","authors":"Shakila Meshkat, Qiaowei Lin, Vanessa K Tassone, Reinhard Janssen-Aguilar, Wendy Lou, Shauna Major, Michael Cooper, Andrew Greenshaw, Venkat Bhat","doi":"10.1177/07067437251347149","DOIUrl":"10.1177/07067437251347149","url":null,"abstract":"<p><p>ObjectivePublic and private mental health-funded services differ in terms of accessibility, affordability, and perceived quality, potentially impacting outcomes. Understanding how different mental health service types and sociodemographic factors correlate with depressive symptoms is critical for informing equitable mental health policies and resource allocation. This study investigates the associations between type of mental health service used and depressive symptoms.MethodData from Mental Health Research Canada's National Poll Understanding the Mental Health of Canadians 2022 to 2024 was analyzed. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Mental health-funded services were classified as public or private. Linear and logistic regressions examined associations with depressive symptom severity (total PHQ-9 scores) and presence of depressive symptoms (PHQ-9 score <math><mo>≥</mo></math> 10). Mediation analysis was conducted to explore the mediating effects of household income on the relationship between funded service type and depressive symptoms.ResultsThe study included 2,072 adults, with 1,000 (47.4%) reporting depressive symptoms. Compared to public services, individuals using private services (<i>n</i> = 880, 41.8%) had lower PHQ-9 scores (aCoef: -1.34, 95% CI [-1.97, -0.70]; <i>p</i> < .001) and lower odds of having depressive symptoms (aOR: 0.74, 95% CI [0.60, 0.91]; <i>p</i> = .004). Household income partially mediated the relationship between funded service type and PHQ-9 scores, accounting for 39.5% of the effect (<i>p</i> < .001), and fully mediated the relationship with the presence of depressive symptoms, with a mediation effect of 40.6%. Additionally, individuals who attended services monthly, weekly, or more frequently had higher odds of having depressive symptoms (aOR: 2.86, 95% CI [1.23, 6.68]; <i>p</i> = .015).ConclusionThis study highlights the complex interplay between mental health service types used, sociodemographic factors, and mental health outcomes. These insights underscore the need to address barriers to effective mental health care access and tailor interventions to individuals' socioeconomic and demographic contexts to optimize outcomes.Plain Language Summary TitleHow Public and Private Mental Health Services Relate to Depression in Canada.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"611-619"},"PeriodicalIF":3.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210336","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":"Evaluation of an Artificial Intelligence and Online Psychotherapy Initiative to Improve Access and Efficiency in an Ambulatory Psychiatric Setting: Évaluation d'une initiative de psychothérapie en ligne basée sur l'intelligence artificielle visant à améliorer l'accès et l'efficacité en milieu psychiatrique ambulatoire.","authors":"Callum Stephenson, Jazmin Eadie, Christina Holmes, Kimia Asadpour, Gilmar Gutierrez, Anchan Kumar, Jasleen Jagayat, Charmy Patel, Saad Sajid, Oleksandr Knyahnytskyi, Megan Yang, Taras Reshetukha, Christina Moi, Tricia Barrett, Amirhossein Shirazi, Vedat Verter, Claudio N Soares, Mohsen Omrani, Nazanin Alavi","doi":"10.1177/07067437251355641","DOIUrl":"10.1177/07067437251355641","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to implement an artificial intelligence-assisted psychiatric triage program, assessing its impact on efficiency and resource optimization.</p><p><strong>Methods: </strong>This project recruited patients on the waitlist for psychiatric evaluation at an outpatient hospital. Participants (<i>n</i> = 101) completed a digital triage module that used natural language processing and machine learning to recommend a care intensity level and a disorder-specific digital psychotherapy program. A psychiatrist also assessed the same information, and the decisions for care intensity and psychotherapy programs were compared with the artificial intelligence recommendations.</p><p><strong>Results: </strong>The overall wait time to receive care decreased by 71.43% due to this initiative. Additionally, participants received psychological care within three weeks after completing the triage module. In 71.29% of the cases, the artificial intelligence-assisted triage program and the psychiatrist suggested the same treatment intensity and psychotherapy program. Additionally, 63.29% of participants allocated to lower-intensity treatment plans by the AI-assisted triage program did not require psychiatric consultation later.</p><p><strong>Conclusions: </strong>Using artificial intelligence to expedite psychiatric triaging is a promising solution to address long wait times for mental health care. With future accuracy refinements, this could be a valuable tool to implement in hospital settings to assist care teams and improve mental health care. This could result in increased care capacity and improved workflow and decision-making.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251355641"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762424","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":"Trends in Healthcare for Drug or Alcohol Use Among Pregnant Women with Disabilities in Ontario Canada.","authors":"Andi Camden, Yona Lunsky, Astrid Guttmann, Simone N Vigod, Isobel Sharpe, Hong Lu, Hilary K Brown","doi":"10.1177/07067437251339794","DOIUrl":"10.1177/07067437251339794","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"649-651"},"PeriodicalIF":3.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081630","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":"Non-Linear Relationships of Loneliness with Age in People Living with Schizophrenia and Non-Psychiatric Comparison Participants: Relations non linéaires entre la solitude et l'âge chez les personnes atteintes de schizophrénie et les personnes n'ayant aucun antécédent de maladie psychiatrique.","authors":"Andrea M Coppola, Jerry McDonald, Amy M Jimenez, Jin Cao, Lucy Shao, Yijia Xue, Bowei Zhang, Luke C Valmadrid, Lisa Eyler, Xin M Tu, Ellen E Lee","doi":"10.1177/07067437251355636","DOIUrl":"10.1177/07067437251355636","url":null,"abstract":"<p><strong>Objective: </strong>Loneliness – distress that arises from discrepancies between perceived and desired relationships – is increasingly prevalent and recognized as a major public health concern due to the association with negative health outcomes. People living with schizophrenia (PLWS) experience higher rates of loneliness than the general population and may be particularly vulnerable to these adverse outcomes. In the general population, loneliness fluctuates throughout the lifespan, but the relationship between loneliness and age in PLWS is not well understood.</p><p><strong>Method: </strong>271 adults, 141 adults with a diagnosis of schizophrenia or schizoaffective disorder (PLWS)and 130 adults with no history of major psychiatric illness (NCs) aged 27–69 completed clinical interviews and self-report measures assessing loneliness, perceived social support, and mental and physical health. Participants also completed blood draws for biomarkers of inflammation and hyperglycaemia. Locally Weighted Scatterplot Smoothing (LOWESS) regression modelling was used to examine potential non-linear relationships between loneliness and age for both groups and to select the polynomial that best fit the observed relationship.</p><p><strong>Results: </strong>We observed an age by diagnostic group interaction (log estimate = −0.005, SE = 0.003) such that PLWS reported higher loneliness scores compared to NCs of similar age. Patterns of loneliness differed with age between diagnostic groups such that loneliness remained relatively stable and high for PLWS while for NCs loneliness increased from age 40 to age 60. In both groups, loneliness was associated with worse self-reported physical health, depression, and, among PLWS, positive symptoms.</p><p><strong>Conclusion: </strong>Results suggest different patterns of loneliness across adulthood for PLWS and NC, reflecting the different social milestones for NCs during this age period that are not as commonly experienced by PLWS, such as marriage, empty nesting and retirement. Loneliness is linked with poor physical and mental health outcomes among PLWS and may be an important target for improving morbidity and mortality for PLWS.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251355636"},"PeriodicalIF":3.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735496","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":"Rare Genetic Variation and Psychosis: Treatment Considerations for Psychiatrists.","authors":"Mark Ainsley Colijn","doi":"10.1177/07067437251339793","DOIUrl":"10.1177/07067437251339793","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251339793"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676618","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":"Analysis of Demographic and Practice Characteristics of Psychiatrists in Three Canadian Provinces: Analyse des caractéristiques démographiques et de la pratique des psychiatres dans trois provinces canadiennes.","authors":"François Gallant, Ridhwana Kaoser, Sandra Peterson, Matt Dahl, Alison L Park, James M Bolton, Myriam Juda, Alan Katz, Jason Morrison, Benoit H Mulsant, Philip G Tibbo, Juveria Zaheer, Paul Kurdyak, M Ruth Lavergne, David Rudoler","doi":"10.1177/07067437251359183","DOIUrl":"10.1177/07067437251359183","url":null,"abstract":"<p><strong>Objective: </strong>To describe demographic and practice characteristics of psychiatrists in British Columbia (BC), Manitoba (MB) and Ontario (ON) and explore how practice characteristics change by psychiatrist sex/gender and years since medical school graduation.</p><p><strong>Method: </strong>We conducted a repeated cross-sectional study of all practising psychiatrists who had patient interactions and submitted billings from the fiscal years (FY) 2012/2013 to 2021/2022 using linked administrative data in BC, MB and ON. Psychiatrist demographic variables included age, sex/gender, years since medical school graduation and their practice location. Psychiatrist practice characteristics included visit and patient volume, service settings and patient diagnoses. We used measures of central tendency to describe demographic and practice characteristics and quantify change over time using percentage change.</p><p><strong>Results: </strong>The number of psychiatrists increased from 2012/2013 to 2021/2022 (percentage change, BC: 15.4%, MB: 20.0%, ON: 11.8%) and kept up with population increases, shown by stable per-capita supply of psychiatrists. The median age of psychiatrists in all provinces decreased over the study period. The percentage of female psychiatrists in practice increased in all provinces, but more in BC and ON than in MB. On average, psychiatrists are seeing a greater number of patients per year in 2021/2022 than in 2012/2013 (percentage change, BC: 14.6%, MB: 6.5%, ON: 11.1%), and more than half of patients are seen, on average, for one or two visits in all three provinces. More patients receive substance use and psychosis diagnoses over the 10-year study.</p><p><strong>Conclusions: </strong>During the past decade, psychiatric practice characteristics show modest changes despite changing psychiatrist demographics and subtle shift towards more consultative practices. While provinces demonstrated similar trends, differences underscore the importance of conducting pan-Canadian analyses to highlight particularities in workforce patterns.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251359183"},"PeriodicalIF":3.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676617","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}