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

{"title":"The Relationship Between Family Dynamics and Help-Seeking and Disclosure of Adolescent Self-Harm and Suicidality: A Population-Representative Study: Relation entre dynamique familiale et recherche d'aide, et dévoilement des actes d'automutilation et de la suicidalité chez les adolescents : étude représentative de la population.","authors":"Nicole G Hammond, Christopher Gravel, Mark A Ferro, Hannah Landry, Marie-Claude Geoffroy, Nicole Racine, Ian Colman","doi":"10.1177/07067437251315526","DOIUrl":"10.1177/07067437251315526","url":null,"abstract":"<p><strong>Background: </strong>Few studies have explored the potential for family dynamics to hinder or promote help-seeking and disclosure behaviours among adolescents who self-harm or experience suicidality. We sought to examine whether family dynamics may influence self-harm-related disclosure to parents or other family members and online help-seeking.</p><p><strong>Methods: </strong>We identified youths, 14-17 years, in the 2014 Ontario Child Health Study (OCHS) who self-reported past-year suicidal ideation (with or without a suicide plan or past suicide attempt[s]) and/or non-suicidal self-harm. The OCHS is a provincially representative, cross-sectional survey. The person most knowledgeable about the adolescent, usually the mother, reported family dynamics: family dysfunction and positive and negative parenting practices. We used logistic regression to generate adjusted odds ratios.</p><p><strong>Results: </strong>A total of 359 adolescents positively endorsed past-year suicidal ideation and/or non-suicidal self-harm. Disclosure and help-seeking were common (≥67.3% and ≥25.6%, respectively). Adolescents experiencing suicidal ideation and greater family dysfunction were more likely to share their suicidal thoughts with non-family compared to not telling anyone (OR = 1.09, 95% CI: 1.01 to 1.18) and were less likely to tell their parents or other family members about their suicidal thoughts when compared to non-family such as teachers, partners, or friends (OR = 0.82, 95% CI: 0.71 to 0.94). Positive parenting was not associated with any form of disclosure or online help-seeking for non-suicidal self-harm or suicidal ideation. As adolescent exposure to negative parenting increased, so did the likelihood that they would seek help online for their suicidal thoughts (OR = 1.22, 95% CI: 1.08 to 1.37). Sensitivity analyses replicated or were very similar to findings from the main models.</p><p><strong>Conclusion: </strong>We found that negative family dynamics were related to reduced sharing of suicidal thoughts with parents or other family members and greater online help-seeking. Our findings suggest that the importance of negative family dynamics to disclosure and support-seeking for adolescent suicidality may be under-recognized.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251315526"},"PeriodicalIF":3.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124154","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 Relationship Between Frontal Cortical Thickness and Externalizing Psychopathology is Associated with Treatment Outcomes in Children with Externalizing Problems: A Preliminary Pilot Study: La relation entre l'épaisseur du cortex frontal et les troubles extériorisés est associée aux résultats thérapeutiques chez les enfants ayant des problèmes extériorisés : une étude pilote préliminaire.","authors":"Lee Propp, Hajer Nakua, Anne-Claude V Bedard, Marcos Sanches, Stephanie H Ameis, Brendan F Andrade","doi":"10.1177/07067437251315519","DOIUrl":"10.1177/07067437251315519","url":null,"abstract":"<p><strong>Objectives: </strong>Children with externalizing disorders commonly show emotion dysregulation and callous-unemotional (CU) traits. However, it is unclear whether emotion dysregulation and CU traits share underlying neurobiology that can be predictive of psychosocial treatment outcomes. In this preliminary study, we examined neural correlates of externalizing psychopathology dimensions and their prediction of treatment outcomes.</p><p><strong>Methods: </strong>We analyzed a pilot sample of 17 children with an externalizing disorder (9-12 years; 10.45 ± 1.02) who underwent structural magnetic resonance imaging (MRI) before participating in a 15-week psychosocial group intervention targeting conduct problems. We examined cross-sectional associations between emotion dysregulation or CU traits and cortical thickness (anterior cingulate cortex [ACC] and insula) and amygdala volume at baseline. We then examined whether the pre-treatment brain-behaviour relationships were linked to reduction in conduct problems post-treatment.</p><p><strong>Results: </strong>Lower ACC and insula thickness as well as amygdala volume was associated with greater levels of emotion dysregulation and CU traits at baseline (pre-treatment, <i>r</i> = |0.36-0.61|). There was a significant three-way interaction between emotion dysregulation/CU traits, left insula/right rostral ACC, and treatment (pre/post; β = -1.01 to 3.6). Overall, greater baseline insular and rostral ACC thickness was related to reductions in conduct problems following group-based psychosocial intervention regardless of baseline emotion dysregulation and CU trait levels.</p><p><strong>Conclusions: </strong>The results provide preliminary evidence of shared neural signatures underlying both emotion dysregulation and CU traits. Additionally, alterations in frontolimbic brain structure may be useful predictors of pre-treatment associations with externalizing psychopathology dimensions and post-treatment behavioural outcomes.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251315519"},"PeriodicalIF":3.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124158","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":"Limitations and Future Directions in Pharmacological Treatment for Amphetamine-Type Stimulant Use Disorder.","authors":"Anees Bahji","doi":"10.1177/07067437241312683","DOIUrl":"10.1177/07067437241312683","url":null,"abstract":"<p><p>Plain Language Summary<i><b>Why Current Treatments for Stimulant Addiction Often Fall Short: Insights and Future Directions</b></i> Stimulant addiction, such as addiction to drugs like amphetamines, is a growing public health concern, but there are very few effective medications to treat it. A recent study reviewed a drug called modafinil and found it didn't help reduce drug use, cravings, or improve treatment outcomes. This article discusses why treatments that work for other addictions, like opioids, are less effective for stimulants. It also highlights the challenges researchers face, such as differences in study methods and overlooking common issues like mental health problems or using multiple substances. The focus on complete abstinence as a treatment goal is another issue. Harm reduction, which involves reducing drug use and improving health and social well-being, could be more realistic and beneficial for many people. Finally, while therapy remains the most effective treatment, it's not always accessible. This article calls for new, innovative approaches that prioritize harm reduction, safety, and long-term recovery.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"136-137"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016822","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 Time-Series Analysis of News Media Coverage of Suicide in Canada from 2019 to 2023: Une analyse de séries chronologiques de la couverture responsable du suicide par les médias au Canada de 2019 à 2023.","authors":"Juliette Careau, Justin Bélair, Rob Whitley","doi":"10.1177/07067437241309677","DOIUrl":"10.1177/07067437241309677","url":null,"abstract":"<p><strong>Objective: </strong>Evidence suggests that the media can play a role in preventing suicide, as well as contributing to suicide contagion. As such, the primary objective is to assess adherence to responsible reporting of suicide recommendations in news articles about suicide over time. A secondary objective is to assess whether reporting changed significantly during the COVID-19 pandemic. The tertiary objective is to assess overall patterns regarding types of suicide reported.</p><p><strong>Methods: </strong>We collected news articles with the keyword \"suicide\" from 47 Canadian news sources between April 1, 2019, and March 31, 2023. Articles were coded for adherence to key responsible reporting of suicide guidelines. Frequency counts and percentages of adherence were calculated for all key variables. Time series analyses using a Generalized Linear Autoregressive Moving Average model assessed for adherence trends over time, including measuring for any changes during the COVID-19 years.</p><p><strong>Results: </strong>Study procedures resulted in 3,232 coded news articles. Overall, the results indicate that adherence to the guidelines has moderately improved over the course of the 4-year period. This is especially true for recommendations regarding avoiding putatively harmful content, such as detailed descriptions of the suicide method. Similar improvements were seen in adherence to guidelines related to the inclusion of putatively helpful content, with significantly more articles providing help-seeking information. However, in the final year of the study, less than a third of articles included educational content about suicide, help-seeking information, or quotes from suicide experts. Reporting of suicide during the COVID-19 period showed some positive improvements; however, these were not sustained after the pandemic ended.</p><p><strong>Conclusions: </strong>On the plus side, adherence to responsible suicide reporting guidelines improved over the 4-year period, especially for recommendations concerning putatively helpful content. However, there remains room for improvement regarding the inclusion of putatively protective content such as including help-seeking information, educating about suicide, and quoting experts.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"98-108"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958672","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":"Sex-stratified Genomic Structural Equation Models of Posttraumatic Stress Inform PTSD Etiology: L'utilisation de la modélisation génomique par équations structurelles stratifiée par sexe du stress post-traumatique pour expliquer l'étiologie du TSPT.","authors":"Ashley Moo-Choy, Murray B Stein, Joel Gelernter, Frank R Wendt","doi":"10.1177/07067437241301016","DOIUrl":"10.1177/07067437241301016","url":null,"abstract":"<p><strong>Objective: </strong>Posttraumatic stress disorder (PTSD) affects 3.9%-5.6% of the worldwide population, with well-documented sex-related differences. While psychosocial and hormonal factors affecting sex differences in PTSD and posttraumatic stress (PTS) symptom etiology have been explored, there has been limited focus on the genetic bases of these differences. Many symptom combinations may confer a PTSD diagnosis. We hypothesized that these symptom combinations have sex-specific patterns, the examination of which could inform etiological differences in PTSD genetics between males and females.</p><p><strong>Methods: </strong>To investigate this, we performed a sex-stratified multivariate genome-wide association study (GWAS) in unrelated UK Biobank (UKB) individuals of European ancestry. Using GWAS summary association data, genomic structural equation modelling was performed to generate sex-specific factor models using 6 indicator variables: trouble concentrating, feeling distant from others, irritability, disturbing thoughts, upset feelings, and avoidance of places/activities which remind the individual of a traumatic event.</p><p><strong>Results: </strong>Models of male and female PTSD symptoms differed substantially (local standardized root mean square difference = 3.12) and significantly (χ²(5) = 28.03, <i>P</i> = 3.6 × 10^-5). Independent 2-factor models best fit the data in both males and females; these factors were subjected to GWAS in each sex, revealing 3 genome-wide significant loci in females, mapping to <i>SCAND3</i>, <i>WDPCP</i>, and <i>FAM120A</i>. No genome-wide significant loci were identified in males. All 4 PTS factors (2 in males and 2 in females) were heritable.</p><p><strong>Conclusions: </strong>By assessing the relationship between sex and PTSD symptoms, this study informs correlative and putatively causal etiological differences between males and females which support further investigation of sex differences in PTSD genetics.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"117-126"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803508","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":"Validation de L’échelle Unidimensionnelle D’Estime de Soi de Ducher (ESD): Validation of Ducher's Unidimensional Self-Esteem Scale (SES).","authors":"I de Chazeron, J-L Ducher, M Renoux, G Brousse, P-M Llorca","doi":"10.1177/07067437241301712","DOIUrl":"10.1177/07067437241301712","url":null,"abstract":"<p><strong>Background: </strong>Although self-esteem is a relatively new concept, first developed in the field of social psychology, it has gained increasing importance in psychiatry, especially as a diagnostic criterion. However, it is poorly evaluated in clinical practice. The lack of an instrument allowing an easy global assessment may be the reason for this. It is therefore a question of validating a short, one-dimensional self-esteem scale in French, possibly allowing an evolutionary follow-up by self-correction.</p><p><strong>Methods: </strong>The study involved 106 patients with various psychiatric disorders, except psychotic disorder, stabilized or of varying severity. The creation of the original tool included 10 items. It was submitted to the selection of items followed by an exploratory factor analysis. The correlation between the items and the measurement of consistency and convergent validity were then performed.</p><p><strong>Result: </strong>The evaluation of acceptability and distribution of results led to the selection of 6 items. Exploratory factor analysis revealed a unique dimension and good reliability (Tucker-Lewis Index = 0.89). No item displays correlations with a total score of less than 0.50 and the concept of construct is consistent. There is also a good internal consistency which confirms that the 6-item ESD version is optimal.</p><p><strong>Conclusion: </strong>This new, validated scale will allow therapists to more accurately investigate the notion of self-esteem in a clinical or research setting.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"109-116"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958807","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":"High Intensity Physician-Based Service Use for Mental Health Concerns in a General-Population Sample of Children and Youth: Utilisation des services de haute intensité dispensés par des médecins pour les problèmes de santé mentale dans un échantillon d'enfants et de jeunes de la population générale.","authors":"Jordan Edwards, Li Wang, Anne E Fuller, Kelly K Anderson, Claire de Oliveira, Katholiki Georgiades","doi":"10.1177/07067437241300961","DOIUrl":"10.1177/07067437241300961","url":null,"abstract":"<p><strong>Objective: </strong>To examine factors associated with high intensity physician-based mental health care services in a population-based sample of children and youth in Ontario, Canada.</p><p><strong>Methods: </strong>Data from the 2014 Ontario Child Health Study (OCHS) were linked at the person-level to longitudinal health administrative databases containing physician contacts in outpatient settings, emergency departments and hospitals. Our analytical sample (15.8% of 9,301, <i>n</i> = 1,423) included children and youth with at least one physician-based contact for a mental health concern in the 24-month period post-OCHS. Over the same follow-up period, we classified high intensity service use as those in the top 10th and fifth percentiles of physician-based mental health service cost contributors. Costs were assessed using physician billing data, as well as estimated emergency department visit and hospitalization costs.</p><p><strong>Results: </strong>Among those with at least one contact, being older (PR: 1.15, 95% CI: 1.04, 1.25), having more severe symptoms of mental ill-health (PR: 1.04, 95% CI: 1.01, 1.06) and having a history of mental health service use (PR: 3.99, 95% CI: 1.37, 11.61), were positively associated with high-intensity service use, while living in a rural setting (PR: 0.35, 95% CI: 0.15, 0.30) was negatively associated. Findings were largely consistent between the top 10th and fifth percentiles. Notably, among youth ages 14-17 years, self-reported prior suicide attempt was positively associated with high-intensity (top fifth percentile) service use (PR: 6.09, 95% CI: 1.41, 26.26).</p><p><strong>Conclusions: </strong>Our findings suggest older age, non-rural residency, mental health symptom severity and suicidal behaviour are important factors associated with high-intensity physician-based mental health service use. Our findings will inform efforts to better identify children and youth who may benefit from early and personalized interventions.</p><p><strong>Plain language summary title: </strong>Understanding Children and Youth with the Greatest Mental Health Related Service Needs.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"127-135"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984132","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":"Strategies for Achieving Better Cognitive Health in Individuals with Schizophrenia Spectrum: A Focus on the Canadian Landscape: Stratégies pour atteindre une meilleure santé cognitive chez les personnes souffrant du spectre de la schizophrénie : un regard sur le paysage canadien.","authors":"Martin Lepage, Synthia Guimond, Thomas Raedler, Heather E McNeely, Thomas Ungar, Howard C Margolese, Michael Best","doi":"10.1177/07067437241261928","DOIUrl":"10.1177/07067437241261928","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia spectrum disorders (SSDs) are a group of psychiatric disorders characterized by positive and negative symptoms as well as cognitive impairment that can significantly affect daily functioning.</p><p><strong>Method: </strong>We reviewed evidence-based strategies for improving cognitive function in patients with SSDs, focusing on the Canadian landscape.</p><p><strong>Results: </strong>Although antipsychotic medications can address the positive symptoms of SSDs, cognitive symptoms often persist, causing functional impairment and reduced quality of life. Moreover, cognitive function in patients with SSDs is infrequently assessed in clinical practice, and evidence-based recommendations for addressing cognitive impairment in people living with schizophrenia are limited. While cognitive remediation (CR) can improve several domains of cognitive function, most individuals with SSDs are currently not offered such an intervention. While the development of implementation strategies for CR is underway, available and emerging pharmacological treatments may help overcome the limited capacity for psychosocial approaches. Furthermore, combining pharmacological with non-pharmacological interventions may improve outcomes compared to pharmacotherapy or CR alone.</p><p><strong>Conclusion: </strong>This review highlights the challenges and discusses the potential solutions related to the assessment and management of cognitive impairment to help mental health-care practitioners better manage cognitive impairment and improve daily functioning in individuals with SSDs.</p><p><strong>Plain language summary title: </strong>Improving Thinking Skills in People With Schizophrenia: A Focus on Canada.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"85-97"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762841","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":"Cognitive Outcomes After Transcranial Magnetic Stimulation for the Treatment of Late-Life Depression: Résultats cognitifs après la stimulation magnétique transcrânienne pour le traitement de la dépression chez les personnes âgées.","authors":"Katharina Göke, Shawn M McClintock, Linda Mah, Tarek K Rajji, Hyewon H Lee, Sean M Nestor, Jonathan Downar, Yoshihiro Noda, Zafiris J Daskalakis, Benoit H Mulsant, Daniel M Blumberger","doi":"10.1177/07067437251315515","DOIUrl":"10.1177/07067437251315515","url":null,"abstract":"<p><strong>Background: </strong>Late-life depression (LLD) is often accompanied by cognitive impairment, which may persist despite antidepressant treatment. Repetitive transcranial magnetic stimulation (rTMS) is an efficacious treatment for depression, with potential benefits on cognitive functioning. However, research on cognitive effects is inconclusive, relatively sparse in LLD, and predominantly focused on group-level cognitive changes. This study aimed to explore individual-level cognitive changes following rTMS treatment in patients with LLD.</p><p><strong>Method: </strong>Data were analyzed from 153 patients with LLD from the FOUR-D study (ClinicalTrials.gov identifier: NCT02998580) who received bilateral standard rTMS or theta burst stimulation (TBS) targeting the dorsolateral prefrontal cortex (DLPFC). Cognitive function was assessed pre- and post-treatment using measures of executive function, information processing speed, and learning and memory. Reliable change indices, adjusted for practice effects and test-retest reliability, were employed to evaluate individual-level cognitive changes. Chi-square tests examined if proportions of cognitive improvers differed from expected proportions.</p><p><strong>Results: </strong>Cognitive performance from baseline to end of treatment remained stable for most patients. Reliably improved performance was observed in 0.0% to 20.0% of participants across cognitive measures, while worsened performance was observed in 0.0% to 2.7%. A small but significant proportion (20.0%) of participants showed improvement in verbal learning.</p><p><strong>Conclusions: </strong>Bilateral standard rTMS or TBS of the DLPFC in LLD yielded no substantial cognitive enhancing effects, although a small proportion showed improved verbal learning after treatment. Importantly, both interventions were cognitively safe with relatively stable performance across time. Future research is needed to explore approaches to enhance the cognitive benefits of standard rTMS and TBS in patients with LLD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251315515"},"PeriodicalIF":3.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069653","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":"Antipsychotic Drug Prescribing in Children Previously Treated With Stimulants for ADHD: A Population-Based Longitudinal Study: La prescription d'antipsychotiques chez les enfants précédemment traités avec des stimulants pour le TDAH : une étude longitudinale basée sur la population.","authors":"Hans J Gober, Kathy H Li, Bruce C Carleton","doi":"10.1177/07067437241309679","DOIUrl":"10.1177/07067437241309679","url":null,"abstract":"<p><strong>Objective: </strong>Stimulant drug treatment in preschool-age children for attention-deficit hyperactivity disorder (ADHD) as well as the concomitant use of antipsychotic drugs is largely unstudied in terms of longitudinal outcomes. We characterized longitudinal patterns of stimulant drug use in children diagnosed for ADHD and analyzed the mental health disorders leading to add-on therapy with antipsychotics.</p><p><strong>Method: </strong>The study population comprised of children and adolescents (age: 0-19 years) in the province of British Columbia (BC), Canada, with at least one dispensing for any psychotropic drug between 1997 and 2017 (<i>N</i> = 144,825). BC health administrative databases were used to identify children with diagnosis for ADHD and dispensings for stimulant and antipsychotic drugs. Longitudinal patterns of drug use and diagnostic codes proximal to the add-on of antipsychotics were assessed.</p><p><strong>Results: </strong><i>We found that residence in rural regions and lack of child psychiatrists are significantly associated with higher rates of stimulant drug prescription in preschool and early school-age children. Residence in rural regions was also associated with a higher rate for the concomitant use of antipsychotics over the course of stimulant treatment. When comparing children starting stimulant therapy before the age of 6 with those starting therapy after 6 years,</i> we found an 82% increase in the likelihood of antipsychotic add-on in those starting stimulants at younger ages (HR: 1.82, 95% CI [1.63-2.04]). Moreover, children starting stimulant therapy before the age of 6 years had 3.57-fold higher rates of diagnostic codes for specific delays in development (ICD-9 315) in close proximity to the antipsychotic add-on.</p><p><strong>Conclusions: </strong>The question remains whether the add-on of antipsychotics is a consequence of insufficient action of the stimulant in ADHD, or required to ameliorate the adverse effects of the stimulant drug. Our result suggests that care need to be taken in the diagnosis for ADHD in children at the age when entering elementary school.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241309679"},"PeriodicalIF":3.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016817","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}