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

{"title":"Polygenic Risk Score Analysis of Antidepressant Treatment Outcomes: A CAN-BIND-1 Study Report: Analyse des résultats du traitement antidépresseur à l'aide des scores de risque polygéniques : Rapport sur l'étude CAN-BIND-1.","authors":"Leen Magarbeh, Samar S M Elsheikh, Farhana Islam, Victoria S Marshe, Xiaoyu Men, Emytis Tavakoli, Martin Kronenbuerger, Stefan Kloiber, Benicio N Frey, Roumen Milev, Claudio N Soares, Sagar V Parikh, Franca Placenza, Stefanie Hassel, Valerie H Taylor, Francesco Leri, Pierre Blier, Rudolf Uher, Faranak Farzan, Raymond W Lam, Gustavo Turecki, Jane A Foster, Susan Rotzinger, Sidney H Kennedy, Daniel J Müller","doi":"10.1177/07067437251329073","DOIUrl":"10.1177/07067437251329073","url":null,"abstract":"<p><p>ObjectiveThe genetic architecture of antidepressant response is poorly understood. This study investigated whether polygenic risk scores (PRSs) for major psychiatric disorders and a personality trait (neuroticism) are associated with antidepressant treatment outcomes.MethodsWe analysed 148 participants with major depressive disorder (MDD) from the Canadian Biomarker Integration Network for Depression-1 (CAN-BIND-1) cohort. Participants initially received escitalopram (ESC) monotherapy for 8 weeks. Nonresponders at week 8 received augmentation with aripiprazole (ARI), while responders continued ESC until week 16. Primary outcomes were remission status and symptom improvement measured at weeks 8 and 16. At week 16, post-hoc stratified analyses were performed by treatment arm (ESC-only vs. ESC + ARI). Eleven PRSs derived from genome-wide association studies of psychiatric disorders (e.g., MDD and post-traumatic stress syndrome (PTSD)) and neuroticism, were analysed for associations with these outcomes using logistic and linear regression models.ResultsAt week 8, a higher PRS for PTSD was nominally associated with a lower probability of remission (odds ratio (OR) = 0.08 [0.014-0.42], empirical <i>p</i>-value = 0.017) and reduced symptom improvement (beta (standard error) = -29.15 (9.76), empirical <i>p</i>-value = 0.019). Similarly, a higher PRS for MDD was nominally associated with decreased remission probability (OR = 0.38 [0.18-0.78], empirical <i>p</i>-value = 0.044). However, none of the results survived multiple testing corrections. At week 16, the stratified analysis for the ESC-only group revealed that a higher PRS for MDD was associated with increased remission probability (empirical <i>p-</i>value = 0.034) and greater symptom improvement (empirical <i>p</i>-value = 0.02). In contrast, higher PRSs for schizophrenia (empirical <i>p</i>-value = 0.013) and attention-deficit hyperactivity disorder (empirical <i>p</i>-value = 0.032) were associated with lower symptom improvement. No significant associations were observed in the ESC + ARI group.ConclusionsThese findings suggest that PRSs may influence treatment outcomes, particularly in ESC monotherapy. Replication in larger studies is needed to validate these observations.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"552-564"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744413","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 and Correlates of Non-Suicidal Self-Injuring Youth Who Do Not Endorse Suicidal Ideation: Prévalence et corrélation de l'automutilation non suicidaire chez des jeunes qui n'ont pas d'idées suicidaires.","authors":"Khrista Boylan, Laura Duncan, Li Wang, Ian Manion, Kathryn Bennett, Ian Colman, Katholiki Georgiades","doi":"10.1177/07067437251337609","DOIUrl":"10.1177/07067437251337609","url":null,"abstract":"<p><p>ObjectivesNon-suicidal self-injury (NSSI) is a common behaviour in youth with mental disorder and in the general population. While NSSI is an important predictor of suicide attempts, not all youth with NSSI experience this outcome. The objective of this study is to report on the overlap between NSSI and suicidal ideation or attempt among Canadian youth self-reporting these behaviours in the general population to define a group of youth who engage in NSSI alone. This group of youth may represent a unique clinical phenotype.MethodsWe used data from 14-17 year olds (<i>N</i> = 2,576) from the 2014 Ontario Child Health Study, a province-wide, cross-sectional, epidemiologic study of child health and mental disorder. Based on their responses to questions about past year experiences of suicidal thoughts and behaviours including NSSI, 6 mutually exclusive groups were created reflecting their differing profiles of suicidal thoughts and behaviours. These groups were compared to each other on socio-demographic and symptom characteristics.ResultsA total of 9.2% of youth reported NSSI, and half of these youth endorsed NSSI alone (without suicidal ideation or attempts). Both groups had significantly more females. Compared to other groups of youth endorsing suicidal thoughts and behaviours, the NSSI alone group had lower symptoms of mental disorder in all domains except for social anxiety symptoms. They also had the lowest perceived need for help of all groups.ConclusionsAbout half of youth who self-harm do so without suicidal intent, and some for as long as 1 year during adolescence. Further prospective study of youth with NSSI alone is needed, to determine symptom stability as well as incident more risky suicidal behaviour before recommendations regarding the appropriateness of minimal medical or psychological intervention for youth who engage in this behaviour can be considered. There also are important sex differences in NSSI that deserve additional prospective study.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"574-582"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082238","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":"Predicting Relapse of Depressive Episodes During Maintenance Treatment: The Canadian Biomarker Integration Network in Depression (CAN-BIND) Wellness Monitoring in Major Depressive Disorder Study: Prédire la rechute d'épisodes dépressifs pendant le traitement d'entretien : Une étude de suivi du bien-être dans les troubles dépressifs majeurs du Réseau canadien d'intégration des biomarqueurs pour la dépression (CAN-BIND).","authors":"Raymond W Lam, Katerina Rnic, John-Jose Nunez, Keith Ho, Joelle LeMoult, Abraham Nunes, Trisha Chakrabarty, Jane A Foster, Benicio N Frey, Kate L Harkness, Stefanie Hassel, Sidney H Kennedy, Qingqin S Li, Roumen V Milev, Lena C Quilty, Susan Rotzinger, Claudio N Soares, Valerie H Taylor, Gustavo Turecki, Rudolf Uher","doi":"10.1177/07067437251337603","DOIUrl":"10.1177/07067437251337603","url":null,"abstract":"<p><p>BackgroundRelapse rates in major depressive disorder (MDD) remain high even after treatment to remission. Identifying predictors of relapse is, therefore, crucial for improving maintenance strategies and preventing future episodes. Remote data collection and sensing technologies may allow for more comprehensive and longitudinal assessment of potential predictors.MethodsThe Canadian Biomarker Integration Network in Depression Wellness Monitoring for MDD (CBN-WELL) study was a prospective, multicentre observational study with an aim to identify biomarkers associated with relapse in patients on maintenance treatment for MDD. Participants had a DSM-5-TR diagnosis of MDD in remission and a Montgomery-Åsberg Depression Rating Scale (MADRS) score ≤14. Participants remained on their baseline medication regimens and were followed bimonthly for up to 2 years. Relapse criteria included MADRS > 22 for 2 consecutive weeks, suicidality or hospitalization, and initiation or change in medication for worsening symptoms. Data collection included clinical assessments, self-report questionnaires, and remote monitoring using wrist-worn actigraphs and smartphones.ResultsA total of 96 participants had follow-up data. Of these, 28.9% experienced a depressive relapse during the study period, with an average time to relapse of 211 days. Baseline depressive severity, as measured by MADRS, was higher in participants who relapsed compared to those who did not, but few other baseline clinical measures differentiated these groups.ConclusionsIndividuals with MDD in remission continued to have high relapse rates despite maintenance treatment. The paucity of clinical factors that predict relapse underscores the need for biomarkers. The CBN-WELL database can be used for future research to integrate multiple predictive factors and to identify objective measures to predict relapse in individuals.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"565-573"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060913","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":"Incidence of Major Depressive Disorder Relapse and Effectiveness of Pharmacologic and Psychological Interventions in Primary Care: A Systematic Review and Meta-Analysis: Incidence de la rechute du trouble dépressif majeur et efficacité des interventions pharmacologiques et psychologiques en soins primaires : revue systématique et méta-analyse.","authors":"Waseem Abu-Ashour, Stephanie Delaney, Alison Farrell, John-Michael Gamble, John Hawboldt, Joanna E M Sale","doi":"10.1177/07067437251322401","DOIUrl":"10.1177/07067437251322401","url":null,"abstract":"<p><p>ObjectiveThis research aims to investigate the relapse rates of major depressive disorder (MDD) within primary care and evaluate the efficacy of relapse prevention therapies. Despite primary care being the common point of contact for MDD patients, there are limited studies around this.MethodsWe included randomized controlled trials and observational studies examining MDD relapse incidence and the effect of pharmacological and non-pharmacological interventions in preventing relapse in primary care. Databases; Medline via Ovid, EMBASE, The Cochrane Library, PsycInfo (ebsco), and Clinical Trials.gov were searched from their inception until September 7, 2022. Joanna Briggs Institute (JBI) appraisal instrument for methodological quality assessment was used. A proportional data analysis estimated the MDD relapse incidence. Therapy effectiveness results were shown as odds ratios with 95% confidence intervals, with heterogeneity explored via subgroup analysis.ResultsOut of the reviewed studies, 35 met the eligibility criteria. Quality appraisal scores varied between 73% and 96%. MDD relapse incidence was divided into subgroups, revealing that both pharmacotherapy and non-pharmacotherapy led to a similar decrease in relapse rates with combination therapies showing further reduction in relapse. Subgroup analyses by study design, follow-up length, date of study and quality of study also yielded noteworthy findings.ConclusionOur findings showed that MDD relapse rates in primary care settings can be effectively reduced by pharmacotherapy, non-pharmacotherapy, or combination therapy. Some psychological interventions might also reduce relapse likelihood. More studies are needed on individual and combined treatments over longer periods to understand their long-term impacts on MDD relapse in primary care.Plain Language Summary TitleHow Often Depression Returns and How Well Treatments Work in Primary Care: A Review of Studies.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"529-551"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651709","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":"Positive Symptoms of Psychosis and International Classification of Diseases 11th Revision (ICD-11) Complex Post-traumatic Stress Disorder: A Network Analysis in a Canadian Sample from Montreal: Symptômes positifs de psychose et trouble de stress post-traumatique complexe (CIM-11): Une analyse de réseau dans un échantillon canadien de Montréal.","authors":"Yafit Levin, Amelie Mazza, Philip Hyland, Thanos Karatzias, Mark Shevlin, Grainne McGinty, Yaakov Hoffman, Eric Lis, Menachem Ben-Ezra, Bachem Rahel","doi":"10.1177/07067437251337645","DOIUrl":"10.1177/07067437251337645","url":null,"abstract":"<p><p>ObjectivesTraumatic experiences constitute a risk factor for developing different psychopathologies, such as post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), and positive symptoms of psychosis. However, on the symptom level, it is still unclear how CPTSD and positive symptoms of psychosis associate with each other. The present study aimed to shed light on these dynamics by investigating the symptoms network of CPTSD and positive symptoms of psychosis.MethodsA network analysis was performed on CPTSD and psychosis symptoms among a Canadian community sample with a history of traumatic life events (<i>n</i> = 747). Measures included the international trauma questionnaire and the mPRIME screen.ResultsIn total, 4.8% of the sample reached the criteria of probable PTSD and 7% fulfilled the criteria of probable CPTSD. PTSD and CPTSD groups had a significantly higher severity of positive symptoms of psychosis compared to the no-disorder group. Network analysis revealed 3 distinct communities of symptoms of PTSD, disturbances in self-organization, and psychosis. Affective dysregulation served as the bridging symptom between the communities. Hearing one's own thoughts aloud was the most central symptom in the network.ConclusionsFindings show that positive symptoms of psychosis can be considered trauma-related responses. Furthermore, interventions targeting affective dysregulation as well as the experience and distress associated with hearing one's own thoughts aloud may contribute to symptom reduction and improved functioning.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"583-592"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082225","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":"Light Modulation Therapy as an Adjunctive Treatment for Perinatal Bipolar Disorder.","authors":"Hirofumi Hirakawa","doi":"10.1177/07067437251356183","DOIUrl":"10.1177/07067437251356183","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251356183"},"PeriodicalIF":3.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531206","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":"Sociodemographic, Lifestyle, and Psychological Factors Associated With Flourishing Mental Health in Young Adults: Facteurs sociodémographiques, liés au mode de vie et psychologiques, associés à une bonne santé mentale chez les jeunes adultes.","authors":"Yasmien Deis, Jennifer O'Loughlin, Isabelle Doré","doi":"10.1177/07067437251347166","DOIUrl":"10.1177/07067437251347166","url":null,"abstract":"<p><strong>Objective: </strong>To identify sociodemographic, lifestyle, and psychological correlates of flourishing mental health (i.e., feeling good and functioning well) in a population-based sample of young adults.</p><p><strong>Method: </strong>Data for this cross-sectional study were drawn from the ongoing Nicotine Dependance in Teens study, Québec, Canada. Of 799 participants in cycle 23, 792 (mean (SD) age = 30.6 (1.0) years) provided data on positive mental health using the Mental Health Continuum - Short Form (MHC-SF) and were retained for analysis. Each potential correlate was studied in an unadjusted model, a model adjusted for age and sex, and a model adjusted for age, sex and other covariates related to the specific correlate of interest.</p><p><strong>Results: </strong>Of 792 participants retained for analysis, 39.4% (39.9% of females; 38.8% of males) reported flourishing mental health. Variables associated with higher odds of flourishing included attended university (OR: 1.44 [1.05, 1.99]), being in a relationship (OR: 1.64 [1.22, 2.21], being employed (OR: 1.97 [1.27, 3.11]), high sleep quality (OR: 3.45 [2.53, 4.73]), meeting leisure screen time guidelines (OR: 2.12 [1.59, 2.85]), and relatively high levels of coping ability (OR: 3.11 [2.58, 3.80]). Variables associated with lower odds of flourishing included living alone (OR: 0.58 [0.38, 0.86]), relatively low household income (OR: 0.37 [0.20, 0.64]), and high depressive (OR: 0.05 [0.01, 0.15]) and anxiety (0.17 [0.09, 0.29]) symptoms.</p><p><strong>Conclusions: </strong>Sociodemographic (education, relationship status, employment status, and income), lifestyle (sleep, screen time), and psychological (coping ability, depressive and anxiety symptoms) factors are correlates of flourishing mental health in this population-based sample of young adults. Results provide a foundation for future research to inform the development of effective programs targeting specific subgroups to promote positive mental health in young adults.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251347166"},"PeriodicalIF":3.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318814","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":"Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders: Guide de pratique 2024 du Canadian Network for Mood and Anxiety Treatments pour le traitement des troubles de l'humeur, des troubles anxieux et des troubles connexes périnatals.","authors":"Simone N Vigod, Benicio N Frey, Crystal T Clark, Sophie Grigoriadis, Lucy C Barker, Hilary K Brown, Jaime Charlebois, Cindy-Lee Dennis, Nichole Fairbrother, Sheryl M Green, Nicole L Letourneau, Tim F Oberlander, Verinder Sharma, Daisy R Singla, Donna E Stewart, Patricia Tomasi, Brittany D Ellington, Cathleen Fleury, Lesley A Tarasoff, Lianne M Tomfohr-Madsen, Deborah Da Costa, Serge Beaulieu, Elisa Brietzke, Sidney H Kennedy, Raymond W Lam, Roumen V Milev, Sagar V Parikh, Arun V Ravindran, Zainab Samaan, Ayal Schaffer, Valerie H Taylor, Smadar V Tourjman, Michael Van Ameringen, Lakshmi N Yatham, Ryan J Van Lieshout","doi":"10.1177/07067437241303031","DOIUrl":"10.1177/07067437241303031","url":null,"abstract":"<p><p>BackgroundThe Canadian Network for Mood and Anxiety Treatments (CANMAT) publishes clinical practice guidelines for mood and anxiety disorders. This CANMAT guideline aims to provide comprehensive clinical guidance for the pregnancy and postpartum (perinatal) management of mood, anxiety and related disorders.MethodsCANMAT convened a core editorial group of interdisciplinary academic clinicians and persons with lived experience (PWLE), and 3 advisory panels of PWLE and perinatal health and perinatal mental health clinicians. We searched for systematic reviews of prevention and treatment interventions for perinatal depressive, bipolar, anxiety, obsessive-compulsive and post-traumatic stress disorders (January 2013-October 2023). We prioritized evidence from reviews of randomized controlled trials (RCTs), except for the perinatal safety of medications where reviews of large high-quality observational studies were prioritized due to the absence of RCT data. Targeted searches for individual studies were conducted when systematic reviews were limited or absent. Recommendations were organized by lines of treatment based on CANMAT-defined levels of evidence quality, supplemented by editorial group consensus to balance efficacy, safety, tolerability and feasibility considerations.ResultsThe guideline covers 10 clinical sections in a question-and-answer format that maps onto the patient care journey: case identification; organization and delivery of care; non-pharmacological (lifestyle, psychosocial, psychological), pharmacological, neuromodulation and complementary and alternative medicine interventions; high-risk clinical situations; and mental health of the father or co-parent. Equity, diversity and inclusion considerations are provided.ConclusionsThis guideline's detailed evidence-based recommendations provide clinicians with key information to promote the delivery of effective and safe perinatal mental healthcare. It is hoped that the guideline will serve as a valuable tool for clinicians in Canada and around the world to help optimize clinical outcomes in the area of perinatal mental health.Plain Language Summary TitleThe Canadian Network for Mood and Anxiety Treatments 2024 Guideline for Helping People with Mood, Anxiety and Related Disorders During Pregnancy and Postpartum.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"429-489"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400851","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":"Regional Variation in Supply and Use of Psychiatric Services in 3 Canadian Provinces: Variation régionale de l'offre de services psychiatriques et de leur utilisation dans trois provinces canadiennes.","authors":"David Rudoler, Ridhwana Kaoser, M Ruth Lavergne, Sandra Peterson, James M Bolton, Matt Dahl, François Gallant, Kimberley P Good, Myriam Juda, Alan Katz, Jason Morrison, Benoit H Mulsant, Alison L Park, Philip G Tibbo, Juveria Zaheer, Paul Kurdyak","doi":"10.1177/07067437251322404","DOIUrl":"10.1177/07067437251322404","url":null,"abstract":"<p><p>ObjectiveTo examine the patterns in the supply and use of psychiatric services in 3 Canadian provinces: British Columbia, Manitoba, and Ontario.MethodsWe conducted a repeated cross-sectional analysis spanning fiscal years 2012/13 to 2021/22, using patient- and psychiatrist-level data aggregated into administrative health regions. Descriptive statistics and linear regression were used to assess patterns and relationships between the per capita number of psychiatrists (\"supply\") and measures of use of psychiatric services (\"utilization\"), including any psychiatrist contact, psychiatric consultation (1-2 visits with the same psychiatrist), and ongoing psychiatric care (3 or more visits with the same psychiatrist).ResultsThe number of psychiatrists per capita remained stable within the 3 provinces during the study period. In 2021/22, Vancouver had the highest number in British Columbia (45 psychiatrists per 100,000 individuals), compared to 14 per 100,000 in lower-supply regions. Toronto had the highest number in Ontario (38 per 100,000), compared to 9 in lower supply regions. Winnipeg had the highest number in Manitoba (25 per 100,000), compared to 7 in the lower supply regions. In 2021/22, the per capita number of psychiatrists was moderately correlated with any psychiatrist contact (<i>R</i>² = 0.290) and ongoing psychiatric care (<i>R</i>² = 0.411), but weakly correlated with psychiatric consultation (<i>R</i>² = 0.005). The relationship between supply and utilization diminishes with higher levels of regional supply.ConclusionsPsychiatrists were unevenly distributed within and across provinces. While more psychiatrists are needed, the moderate and diminishing relationships between their numbers and utilization suggest that increasing this number alone is unlikely to fully address unmet needs for mental healthcare. Strategies to improve access will need to directly target uneven distributions. Further research is needed to understand the factors influencing psychiatrists' practice choices and ways to better support them in increasing their access to care.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"511-523"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733346","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":"Commentary on the Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety and Related Disorders: Evidence-Based Treatments Require Appropriate Systems of Care to Be Implemented.","authors":"Philip Boyce","doi":"10.1177/07067437241311620","DOIUrl":"10.1177/07067437241311620","url":null,"abstract":"<p><p>Plain Language Summary<i><b>This is a commentary of the CANMAT guideline</b></i>Key points about the CANMAT perinatal guidelines are commented on. The process of developing the guidelines was robust and there can be a high level of confidence in their recommendations. An important aspect is that services for women with perinatal mood and anxiety disorders need to put in place so that the range on evidence based treatments can be implemented.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"490-492"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958673","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}