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

{"title":"Capacity to Consent to Treatment of Substance Use Disorders at Ontario's Consent and Capacity Board: A Review of Past Reported Decisions.","authors":"Tanya S Hauck, Rachel Goud, Michele Warner, Susan Franchuk, Juveria Zaheer, Vicky Stergiopoulos, Victor M Tang, Leslie Buckley","doi":"10.1177/07067437241261488","DOIUrl":"10.1177/07067437241261488","url":null,"abstract":"<p><strong>Plain language summary title: </strong>An Ontario review of legal cases which have considered patients' ability to consent to substance use treatments.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"781-783"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319001","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":"Prevalence of Common Child Mental Health Disorders Using Administrative Health Data and Parent Report in a Prospective Community-Based Cohort from Alberta, Canada: Prévalence des troubles communs de santé mentale de l'enfant à l'aide des données de santé administratives et des rapports des parents dans une cohorte prospective communautaire d'Alberta, Canada.","authors":"N Racine, T Pitt, S Premji, S W McDonald, S B Patten, S Tough, S Madigan","doi":"10.1177/07067437241271708","DOIUrl":"10.1177/07067437241271708","url":null,"abstract":"<p><strong>Objective: </strong>Knowing the prevalence of mental health difficulties in young children is critical for early identification and intervention. In the current study, we examine the agreement among three different data sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age.</p><p><strong>Methods: </strong>Data from a prospective pregnancy cohort was linked with provincial administrative health data for children in Alberta, Canada. We report the positive agreement, negative agreement, and Cohen's Kappa of parent-reported child diagnoses provided by a health professional (\"parent report\"), exceeding a clinical cut-off on a standardized questionnaire completed by parents (the Behavior Assessment System for Children, 3rd edition [\"BASC-3\"]), and cumulative inpatient, outpatient, or physician claims diagnoses (\"administrative data\").</p><p><strong>Results: </strong>Positive and negative agreement for administrative data and parent-reported ADHD diagnoses were 70.8% and 95.6%, respectively, and 30.5% and 94.9% for administrative data and the BASC-3, respectively. For emotional disorders, administrative data and parent-reported diagnoses had a positive agreement of 35.7% and negative agreement of 96.30%. Positive and negative agreement for emotional disorders using administrative data and the BASC-3 were 20.0% and 87.4%, respectively. Kappa coefficients were generally low, indicating poor chance-corrected agreement between these data sources.</p><p><strong>Conclusions: </strong>The data sources highlighted in this study provide disparate agreement for the prevalence of ADHD and emotional disorder diagnoses in young children. Low Kappa coefficients suggest that parent-reported diagnoses, clinically elevated symptoms using a standardized questionnaire, and diagnoses from administrative data serve different purposes and provide discrete estimates of mental health difficulties in early childhood.</p><p><strong>Plain language title: </strong>Prevalence of child mental health disorders according to different data sources in Canada.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"768-777"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019664","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":"An Epidemiological Study of Physical-Mental Multimorbidity in Youth: Une étude épidémiologique de la morbidité physique-mentale chez les jeunes.","authors":"Shannon V Reaume, Joel A Dubin, Christopher Perlman, Mark A Ferro","doi":"10.1177/07067437241271713","DOIUrl":"10.1177/07067437241271713","url":null,"abstract":"<p><strong>Objective: </strong>This epidemiological study estimated the lifetime prevalence of chronic physical illness (i.e., an illness that lasted or was expected to last ≥6 months) and 6-month prevalence of mental disorder and multimorbidity (i.e., ≥1 physical illness and ≥1 mental disorder) in youth. Associations between physical illness and mental disorder were quantified, including the number of illnesses. Secondary objectives examined factors associated with mental disorder, after controlling for physical illness.</p><p><strong>Methods: </strong>Data come from 10,303 youth aged 4-17 years in the 2014 Ontario Child Health Study (OCHS). Physical illness was measured using a list of chronic conditions developed by Statistics Canada. Mental disorders were measured using the OCHS Emotional Behavioural Scales. The Health Utility Index Mark III assessed overall functional health.</p><p><strong>Results: </strong>Weighted prevalence estimates showed 550,090 (27.8%) youth had physical illness, 291,986 (14.8%) had mental disorder, and 108,435 (5.4%) had multimorbidity. Physical illness was not associated with mental disorder. However, youth with 2 physical illnesses, as compared to no physical illnesses, had increased odds of having any mental (OR = 1.75 [1.08, 2.85]), mood (OR = 2.50 [1.39, 4.48]) and anxiety disorders (OR = 2.40 [1.33, 4.31]). Mean functional health scores demonstrated a dose-response association across health status categories, with the highest scores among healthy youth and the lowest scores among multimorbid youth (all <i>p </i>< .05).</p><p><strong>Conclusion: </strong>Chronic physical illness and mental disorders are prevalent in youth. Youths with 2 physical illnesses have a higher likelihood of mental disorders. Higher functional health scores protected against all mental disorders. Mental health interventions for youth should promote strong overall functional health.</p><p><strong>Plain language summary title: </strong>Physical-Mental Multimorbidity in Ontario Youth.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"749-758"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989556","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":"Effect of Bright Light Therapy on Perinatal Depression: A Systematic Review and Meta-Analysis: Effet de la luminothérapie sur la dépression périnatale: une revue systématique et une méta-analyse.","authors":"Yujia Chen, Jing Zhao, Jiarun Wang, Li Peng, Zhongxiang Cai, Zhijie Zou, Xiaoli Chen","doi":"10.1177/07067437241248051","DOIUrl":"10.1177/07067437241248051","url":null,"abstract":"<p><strong>Objective: </strong>This study represents the inaugural attempt to systematically review and analyse the efficacy of bright light therapy on depression among women experiencing major depressive disorder or depressive symptoms during the perinatal period, encompassing its efficacy on depression scores, remission rates, and response rates.</p><p><strong>Methods: </strong>We searched 10 databases for randomized controlled trials examining bright light therapy's efficacy on perinatal depression up to January 2024. Data extraction was performed independently by 2 investigators. The Cochrane Handbook guidelines appraised the study quality, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach assessed evidence certainty.</p><p><strong>Results: </strong>We incorporated 6 studies, encompassing 151 participants. When contrasted with dim light therapy, bright light therapy did not significantly alter depression scores (standard mean difference = -0.29, 95% confidence interval [CI], -0.62 to 0.04, <i>P</i> = 0.08, <i>I</i>² = 34%) or response rates (risk ratio [RR] = 1.56, 95% CI, 0.98 to 2.49, <i>P</i> = 0.06, <i>I</i>² = 0%) in women experiencing perinatal depression. Conversely, bright light therapy was associated with a substantial increase in remission rates (RR = 2.63, 95% CI, 1.29 to 5.38, <i>P</i> = 0.008, <i>I</i>² = 2%).</p><p><strong>Conclusion: </strong>Bright light therapy did not show efficacy in treating perinatal depression in terms of depression scores and response rates. However, regarding the remission rate, bright light did show efficacy compared to control conditions. Due to the limited sample size in the included studies, type II err or may occur. To obtain more conclusive evidence, future studies must employ larger sample sizes.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"737-748"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307482","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":"Urinary Retention Following Electro-Convulsive Therapy Under General Mask Anesthesia.","authors":"Anthony A Stephenson, Martin D Abel, Juraj Sprung, Robert J Morgan, Darrell R Schroeder, Toby N Weingarten","doi":"10.1177/07067437241271738","DOIUrl":"10.1177/07067437241271738","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"778-780"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009974","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 francophone de la CASIG-rev – un outil clinique visant à soutenir le rétablissement des personnes avec un trouble psychiatrique: French validation of the CASIG-rev – a clinical personal recovery assessment for people with psychiatric disorders.","authors":"Tania Lecomte, Isabelle Heyden, Stéphane Raffard, Yasser Khazaal, Audrey Livet, Paméla Power, Marc-André Roy, Amal Abdel-Baki, Marc Corbière","doi":"10.1177/07067437241261481","DOIUrl":"10.1177/07067437241261481","url":null,"abstract":"<p><strong>Objective: </strong>There are few tools capable of measuring the personal recovery of individuals presenting with mental disorders that take into account the various dimensions of recovery. Personal recovery encompasses several objectives at the level of autonomy, positive interpersonal relationships, mental and physical health, self-acceptance, the school/professional domain, as well as developing a life project. A team of practitioners and researchers from four countries (Canada, Belgium, France, and Switzerland) adapted the Client Assessment of Strengths, Interests, and Goals (CASIG) tool to more accurately measure these different aspects of personal recovery. This study aims to validate the revised version of CASIG (CASIG-rev) in French, in terms of construct validity, test-retest reliability, convergent validity, and clinical sensitivity to change.</p><p><strong>Method: </strong>A total of 272 individuals were recruited across different French-speaking countries to respond to the CASIG-rev online, as well as Ryff's well-being measure, the Recovery Assessment Scale, and the WHODAS. A subgroup of 29 individuals responded again to the CASIG-rev after 1 month (for temporal stability), and 24 again at six months (for sensitivity to change).</p><p><strong>Results: </strong>The confirmatory factor analysis suggests a 5-factor model, very similar to the initially proposed model of 6 factors. Convergent validity was demonstrated between the subscales of tools measuring similar concepts, and test-retest reliability was proven for the majority of scales. The CASIG-rev also appears to be sensitive to clinical or rehabilitation changes, notably at the level of the life project.</p><p><strong>Conclusion: </strong>This study supports the use of the CASIG-rev in French to measure the recovery of individuals presenting with mental disorders, as well as to support practitioners in the evaluation of their programs and interventions. Limitations, as well as the tool's relevance, are presented. An English validation is underway to make the CASIG-rev available in Anglo-Saxon countries.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"759-767"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735728","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":"Emotion Regulation Self-Efficacy as a Mechanism of Alliance and Outcomes in a Brief, Transdiagnostic Digital Mental Health Intervention: L'auto-efficacité de la régulation des émotions en tant que mécanisme d'alliance et de résultats dans une brève intervention transdiagnostique numérique en santé mentale.","authors":"Natalia Macrynikola, Sarah Chang, John Torous","doi":"10.1177/07067437241274201","DOIUrl":"10.1177/07067437241274201","url":null,"abstract":"<p><strong>Objectives: </strong>Digital mental health interventions have shown promise for alleviating various forms of psychopathology, including depression and anxiety. However, the mechanisms of such interventions remain largely unexplored. The purpose of this study was to investigate a potential mechanistic process through which one hybrid digital mental health intervention (i.e., the Digital Clinic) might operate. We hypothesized that emotion regulation (ER) self-efficacy at the treatment midpoint may mediate the relationship between alliance (i.e., therapeutic alliance and digital alliance) and outcome (i.e., co-morbid symptoms of depression and anxiety) at the treatment endpoint.</p><p><strong>Methods: </strong>Data used in this study came from the Digital Clinic, a brief transdiagnostic telehealth treatment program augmented by a dual-purpose digital phenotyping and intervention smartphone app. Recruited primarily from primary care, participants were 82 adults (73% White, 64% cisgender women, mean age 41) receiving outpatient treatment in the northeastern United States. All constructs were measured with validated scales, including The Working Alliance Inventory-Short Revised (WAI-SR) for therapeutic alliance, the Digital Working Alliance Inventory (DWAI) for digital alliance, the PROMIS Self-Efficacy for Managing Emotions Short Form scale for ER self-efficacy, and the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) for co-morbid symptoms of depression and anxiety.</p><p><strong>Results: </strong>Significant reductions in co-morbid symptoms of depression and anxiety and significant increases in ER self-efficacy were found from baseline to treatment endpoint. Therapeutic and digital alliance at the midpoint each predicted reductions in co-morbid symptoms of depression and anxiety at the endpoint through ER self-efficacy, controlling for baseline scores.</p><p><strong>Conclusions: </strong>Findings suggest that ER self-efficacy may be a proximal predictor of clinical improvement that may be enhanced by therapeutic and digital alliance. Future controlled research is essential to improve knowledge of the mechanisms of digital mental health interventions and to enhance their effectiveness.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437241274201"},"PeriodicalIF":4.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301446","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":"Comparing the Efficacy of Electronically Delivered Cognitive Behavioral Therapy (e-CBT) to Weekly Online Mental Health Check-Ins for Generalized Anxiety Disorder-A Randomized Controlled Trial: Comparaison de l'efficacité de la thérapie cognitivo-comportementale délivrée par voie électronique (e-TCC) aux contrôles hebdomadaires en ligne de santé mentale pour le trouble d'anxiété généralisée - un essai randomisé contrôlé.","authors":"Melinaz Barati Chermahini, Jazmin Eadie, Anika Agarwal, Callum Stephenson, Niloufar Malakouti, Niloofar Nikjoo, Jasleen Jagayat, Vineeth Jarabana, Amirhossein Shirazi, Anchan Kumar, Tessa Gizzarelli, Gilmar Gutierrez, Ferwa Khan, Charmy Patel, Megan Yang, Mohsen Omrani, Nazanin Alavi","doi":"10.1177/07067437241261933","DOIUrl":"10.1177/07067437241261933","url":null,"abstract":"<p><strong>Background: </strong>Generalized anxiety disorder (GAD) is a prevalent anxiety disorder characterized by uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is one of the first-line treatments that has demonstrated high efficacy in reducing symptoms of anxiety. Electronically delivered CBT (e-CBT) has been a promising adaptation of in-person treatment, showing comparable efficacy with increased accessibility and scalability. Finding further scalable interventions that can offer benefits to patients requiring less intensive interventions can allow for better resource allocation. Some studies have indicated that weekly check-ins can also lead to improvements in GAD symptoms. However, there is a lack of research exploring the potential benefits of online check-ins for patients with GAD.</p><p><strong>Objective: </strong>This study aims to investigate the effects of weekly online asynchronous check-ins on patients diagnosed with GAD and compare it with a group receiving e-CBT.</p><p><strong>Methods: </strong>Participants (<i>n</i> e-CBT = 45; <i>n</i> check-in = 51) with GAD were randomized into either an e-CBT or a mental health check-in program for 12 weeks. Participants in the e-CBT program completed pre-designed modules and homework assignments through a secure online delivery platform where they received personalized feedback from a trained care provider. Participants in the mental health check-in condition had weekly asynchronous messaging communication with a care provider where they were asked structured questions with a different weekly theme to encourage conversation.</p><p><strong>Results: </strong>Both treatments demonstrated statistically significant reductions in GAD-7-item questionnaire (GAD-7) scores over time, but when comparing the groups there was no significant difference between the treatments. The number of participants who dropped out and baseline scores on all questionnaires were comparable for both groups.</p><p><strong>Conclusions: </strong>The findings support the effectiveness of e-CBT and mental health check-ins for the treatment of GAD.</p><p><strong>Plain language summary title: </strong>Comparing the Effectiveness of Electronically Delivered Therapy (e-CBT) to Weekly Online Mental Health Check-ins for Generalized Anxiety Disorder-A Randomized Controlled Trial.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"695-707"},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735726","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 des Troubles Cognitifs Chez des Patients Tunisiens Atteints de Trouble Bipolaire en Rémission : Étude Cas-Témoins: Assessment of Cognitive Impairment in Tunisian Patients With Bipolar Disorder in Remission: A Case-Control Study.","authors":"Nada Charfi, Amal Bouaziz, Sana Omri, Imen Gassara, Rim Feki, Najeh Smaoui, Lobna Zouari, Mohamed Maâlej, Jihène Ben Thabet, Manel Maâlej Bouali","doi":"10.1177/07067437241253631","DOIUrl":"10.1177/07067437241253631","url":null,"abstract":"<p><strong>Objectives: </strong>Our aims were to assess cognitive impairment in bipolar patients in remission compared with healthy controls, and to study its connection to clinical and therapeutic factors.</p><p><strong>Methodology: </strong>This was a case-control study of patients with bipolar disorder (BD) in remission and matched healthy controls. It was carried out at the Hédi Chaker University Hospital in Sfax, Tunisia. The Screen for Cognitive Impairment in Psychiatry (SCIP) scale was used to assess cognitive function in patients and controls. This scale comprises subtests for verbal learning with immediate (VLT-I) and delayed (VLT-D) recall, working memory (WMT), verbal fluency (VFT) and information processing speed (PST).</p><p><strong>Results: </strong>We recruited 61 patients and 40 controls. Compared with controls, patients had significantly lower scores on the overall SCIP scale and on all SCIP subtests (<i>p</i> < 0.001 throughout) with moderate to high effects. In multivariate analysis, the presence of psychotic characteristics correlated with lower scores on the overall SCIP (<i>p</i> = 0.001), VLT-I (<i>p</i> = 0.001) and VLT-D (<i>p</i> = 0.007), WMT (<i>p</i> = 0.002) and PST (<i>p</i> = 0.008). Bipolar II correlated with lower LTV-I scores (<i>p</i> = 0.023). Age of onset and duration of the disorder were negatively correlated with PST scores (<i>p</i> < 10^-3 and <i>p</i> = 0.007, respectively). Predominantly manic polarity correlated with lower VFT scores (<i>p</i> = 0.007).</p><p><strong>Conclusions: </strong>Our study showed that bipolar patients in remission presented significantly more marked cognitive impairments, affecting various cognitive domains, than the controls. These cognitive impairments appear to be linked to clinical and therapeutic factors that are themselves considered to be factors of poor prognosis in BD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"717-726"},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089474","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":"Modifiable Risk Factors Associated With Cognitive Decline in Late Life Depression: Findings From the Canadian Longitudinal Study on Aging: Facteurs de risque modifiables associés au déclin cognitif dans la dépression en fin de vie : constatations de l'Étude longitudinale canadienne sur le vieillissement.","authors":"Melissa Wong, Alex Kiss, Nathan Herrmann, Krista L Lanctôt, Damien Gallagher","doi":"10.1177/07067437241255095","DOIUrl":"10.1177/07067437241255095","url":null,"abstract":"<p><strong>Objective: </strong>Depression in later life is associated with a two-fold increased risk of dementia. It is not clear to what extent potentially modifiable risk factors account for this association.</p><p><strong>Method: </strong>Older adults (age 50 + ) with objective health measures (<i>n</i> = 14,014) from the Canadian Longitudinal Study on Aging were followed for a mean duration of 35 months. Linear regression analyses were used to determine if clinically significant depression (Centre for Epidemiologic Studies Depression scale score (CESD) ≥ 10) was associated with global cognitive decline, assessed with a neuropsychological battery during follow-up, and if modifiable risk factors mediated this association.</p><p><strong>Results: </strong>Depression was associated with an excess of risk factors for cognitive decline including: vascular disease, hypertension, diabetes, apnoea during sleep, higher body mass index, smoking, physical inactivity and lack of social participation. In regression analyses depression remained independently associated with cognitive decline over time (beta -0.060, <i>P</i> = 0.038) as did cerebrovascular disease (beta -0.197, <i>P</i> < 0.001), HbA1C (beta -0.059, <i>P</i> < 0.001), visual impairment (beta -0.070, <i>P</i> = 0.007), hearing impairment (beta -0.098, <i>P</i> < 0.001) and physical inactivity (beta -0.075, <i>P</i> = 0.014). In mediation analyses, we found that cerebrovascular disease (<i>z</i> = -3.525, <i>P</i> < 0.001), HbA1C (<i>z</i> = -4.976, <i>P</i> < 0.001) and physical inactivity (<i>z</i> = -3.998, <i>P</i> < 0.001) partially mediated the association between depression and cognitive decline.</p><p><strong>Conclusions: </strong>In this large sample of Canadian older adults incorporating several objective health measures, older adults with depression were at increased risk of cognitive decline and had an excess of potentially modifiable risk factors. Clinicians should pay particular attention to control of diabetes, physical inactivity and risk factors for cerebrovascular disease in older adults presenting with depression as they can contribute to accelerated cognitive decline and may be addressed during routine clinical care.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"708-716"},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946600","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}