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

{"title":"Sex Differences in the Neuropsychiatric Symptoms of Multiple Sclerosis: Symptômes neuropsychiatriques de la sclérose en plaques: différences selon le sexe.","authors":"David E Freedman, Jiwon Oh, Gillian Einstein, Anthony Feinstein","doi":"10.1177/07067437261425067","DOIUrl":"10.1177/07067437261425067","url":null,"abstract":"<p><p>ObjectiveThere are clinical and radiological sex differences in people with multiple sclerosis (pwMS); however, the influence of sex on the neuropsychiatric symptoms of MS remains unclear. This study aimed to clarify whether there are sex differences in the neuropsychiatric symptoms of MS.MethodA consecutive clinical cohort of 1530 pwMS completed the Hospital Anxiety and Depression Scale for symptoms of anxiety (HADS-A) and depression (HADS-D), the Modified Fatigue Impact Scale (MFIS), the Perceived Deficits Questionnaire (PDQ) for subjective cognitive concerns, and the Minimal Assessment of Cognitive Function in MS neurocognitive battery. Linear regression analyses were undertaken to predict neuropsychiatric raw scores from sex, adjusting for age, educational years, Expanded Disability Status Scale (EDSS) scores, disease duration, and disease subtype. The significance threshold was set at <i>p</i> < .01.ResultsMean age was 43.2 years (SD = 10.6), mean disease duration was 9.7 years (SD = 8.4), and median EDSS was 2.0 (IQR = 1.5-3.5). Seventy-three percent of participants were female. Controlling for covariates, females had higher MFIS, PDQ, California Verbal Learning Test, and Brief Visuospatial Memory Test total learning scores, and lower Judgment of Line Orientation and Paced Auditory Serial Addition Test scores than males, all <i>p</i> < .01. Sex was not independently predictive of scores on the HADS-A, HADS-D, Controlled Oral Word Association Test, Brief Visuospatial Memory Test delayed recall, Symbol Digit Modalities Test, or Delis-Kaplan Executive Function System.ConclusionsAmong pwMS, females experience greater fatigue, cognitive complaints, and dysfunction in spatial rotation and working memory than males, while males have elevated learning/memory difficulties. The absence of differences in symptoms of depression and anxiety between males and females contrasts with well-described sex differences in the general population. These data support future research that can explain sex-specific mechanisms of neuropsychiatric symptoms in pwMS.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"612-622"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319131","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":"Family-Focused Recommendations in Canadian Guidelines for Early Intervention Services for Psychosis: A Systematic Review: Recommandations axées sur la famille dans les Lignes directrices canadiennes relatives aux services d'intervention précoce en cas de psychose : Une revue systématique.","authors":"Helen Martin, Ruben Valle, Nicole Pawliuk, Srividya N Iyer","doi":"10.1177/07067437251393981","DOIUrl":"10.1177/07067437251393981","url":null,"abstract":"<p><p>BackgroundDespite well-known benefits of family involvement and interventions, gaps remain in their implementation in early intervention for psychosis. Guidelines have been developed for early psychosis services to bridge evidence-implementation gaps. Little attention has been paid to their nature, quality and recommendations regarding family involvement and interventions. We aimed to identify, describe, and appraise family-focused recommendations in Canadian early psychosis guidelines.MethodsWe conducted a systematic review (PROSPERO#CR042020208974), including Canadian guidelines/standards for first-episode psychosis/early intervention in psychosis, or for psychosis/schizophrenia with a section on first-episode psychosis/early intervention for psychosis. The search was conducted in Google and Google Advanced of 58 websites (April 2024). From each document, bibliographic information and family-focused recommendations were extracted. All family-focused recommendations were subject to content analysis and mapped against a patient and family engagement framework. All guidelines were appraised using Appraisal of Guidelines Research & Evaluation-Recommendation EXcellence (AGREE-REX), assessing rigor and implementability. Family-focused recommendations were rated on three AGREE-REX items. Findings were narratively synthesized.ResultsSeven documents were included, with five provincial early psychosis guidelines and two Canada-wide schizophrenia-spectrum guidelines. 96 family-focused recommendations were extracted covering 21 themes (19 appeared in ≤4 guidelines; two (family psychoeducation; involving families in treatment-planning) in five guidelines). No guidelines had recommendations regarding families in inpatient care; only two guidelines had recommendations for navigating consent vis-à-vis family involvement. 77.4% of recommendations were about direct care; 22.5% about involving families in organizational design/governance; and none about policymaking involvement. AGREE-REX ratings for relevant outcomes and local applicability were lower for family-focused recommendations than overall guidelines. Most guidelines fared poorly in eliciting families' values/preferences.ConclusionFew family-focused recommendations featured consistently across early psychosis guidelines. There was little guidance on navigating barriers to family involvement. Our analysis revealed critical gaps, including in viewing families as partners in treatment decision-making and services/policy design. Future guidelines must integrate stakeholders' values/preferences and guidance on real-world implementation.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"593-605"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12695600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727345","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 Mental Health Risk from Early-Life Adversity: A Population-Based Study of Canadian Adults: Prédiction du risque pour la santé mentale liée à l'adversité en début de vie : Étude fondée sur une population d'adultes canadiens.","authors":"Dylan Johnson, Victoria Parker, Mark Wade","doi":"10.1177/07067437261442418","DOIUrl":"10.1177/07067437261442418","url":null,"abstract":"<p><p>ObjectivesBuilding on prior population-level studies, this replication study explored the predictive accuracy of retrospectively-reported early-life adversity (ELA) for individual psychopathology risk in a Canadian population survey, with measurements focused on direct/severe ELA and occurring during the COVID-19 pandemic.MethodsNationally-representative, cross-sectional data from 7,608 Canadians surveyed in 2022 were analysed. Group-level differences were assessed via logistic regression, and predictive accuracy of ELA was tested via area under the curve (AUC) analyses.ResultsGroup-based analyses found that the odds of mental health problems rose with increasing ELA, albeit nonlinearly. Across psychopathology domains, predictive accuracy was poor (AUC = 0.62-0.67). Using a high-risk cut-off of ≥4 ELAs, sensitivity values were low (0.14-0.23), while specificity was high (0.93-0.94). Similarly, positive predictive values were low (0.08-0.22), while negative predictive values were high (0.92-0.97).ConclusionsELA screening performs poorly at the individual level. While high-risk cut-offs may rule out poor mental health for individuals with fewer ELAs, it fails to accurately identify those with psychopathology. Predictive accuracy does not improve under conditions of collective stress or by focusing on direct/severe ELA. Presently, ELA screening is unsuitable for guiding intervention allocation. Further research is needed to determine whether screening can be refined to improve mental health risk prediction.Plain Language Summary TitleEarly-life adversity and adult mental health: Is Canadian screening getting it right?</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"645-655"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724664","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 New Unifying Definition of Resilience Adapted to the Developmental Psychopathology of Major Psychiatric Disorders: A Requisite for Progress.","authors":"Yasmine Nadifi, Ileana Andrada Popa, Laurence Brochu, Gabrielle Girard, Michel Maziade","doi":"10.1177/07067437251412627","DOIUrl":"10.1177/07067437251412627","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"606-611"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12783031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936512","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":"Functionality in Clinically Recovered Subjects with Obsessive-Compulsive Disorder: A Case-Control Study: Capacité fonctionnelle des sujets atteints d'un trouble obsessionnel-compulsif qui obtiennent un rétablissement clinique - Étude cas-témoins.","authors":"T S Jaisoorya, Paulomi M Sudhir, Thennarassu Kandavel, Y C Janardhan Reddy","doi":"10.1177/07067437261442377","DOIUrl":"10.1177/07067437261442377","url":null,"abstract":"<p><p>ObjectiveA proportion of patients suffering from obsessive-compulsive disorder (OCD) achieves clinical recovery. However, research is sparse on the functional recovery of clinically recovered subjects with OCD. This study examines functionality in clinically recovered OCD subjects compared to healthy controls (HCs).MethodPatients who had clinically recovered from OCD (<i>n</i> = 102) were compared to HCs (<i>n</i> = 52) with respect to global functioning, well-being, disability, and quality of life (QOL) using the Global Assessment of Functioning (GAF) Scale, the WHO-5 Well-Being Scale, the WHO-Disability Assessment Schedule, and the WHO-Quality of Life-Brief Version respectively. They also underwent a comprehensive neuropsychological assessment.ResultsClinically recovered OCD patients had lower global functioning, higher disability scores, impaired environment QOL, and poorer neuropsychological performance in the domains of working memory and response inhibition compared to HCs. In the Spearman's correlation analysis, better global functioning in clinically recovered OCD patients correlated with a longer period of clinical recovery, receiving pharmacological augmentation, not receiving cognitive behavioural therapy, lower disability scores, a higher well-being score, and a higher total QOL score. Neuropsychological correlates of better functioning included faster processing speed and greater accuracy in working memory tasks. In a stepwise quantile (median) regression analysis, improved functioning was associated with an older age of onset, longer duration of remission, faster processing speed, better working memory, lower total disability scores, and higher total QOL scores.ConclusionsClinically recovered OCD patients have a lower functionality. Functional recovery may be defined as clinical recovery and a GAF score of >70 (no more than slight impairment in functioning and minimal symptoms, if any). It is important to identify those who have not achieved functional recovery and offer interventions, including cognitive remediation to improve functional outcomes.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"634-644"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730802","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":"Optimizing Health for Canadian Youth at Clinical High Risk for Psychosis: A Feasibility Study: Optimiser la santé des jeunes Canadiens présentant un risque clinique élevé de psychose : Une étude de faisabilité.","authors":"Yun Lu, Beatrice Todesco, Lisa D Hawke, Nicole Kozloff, Gillian Strudwick, Michael Kiang, Wei Wang, David Castle, George Foussias, Muhammad Omair Husain","doi":"10.1177/07067437261436536","DOIUrl":"10.1177/07067437261436536","url":null,"abstract":"<p><p>ObjectiveWe adapted and evaluated a transdiagnostic psychosocial intervention, the Optimal Health Program (OHP), to meet the unique mental health needs of youth at clinical high risk for psychosis (CHR). This study aimed to establish the acceptability of OHP for CHR (OHP-CHR), the feasibility of conducting a confirmatory clinical trial, and the preliminary efficacy of the intervention in improving clinical and functional outcomes.MethodsIn this single-arm clinical trial, youth aged 16-29 years meeting CHR criteria were recruited between September 2023 and August 2024. Nine OHP-CHR sessions were delivered over 12 weeks. Acceptability of the intervention was assessed through session attendance rates and the Client Satisfaction Questionnaire (CSQ-8). Feasibility of conducting a confirmatory clinical trial was informed by recruitment, retention, adherence, intervention fidelity, and completion of the outcome schedule. Psychiatric symptoms, resilience, and functioning were assessed at baseline and after 12 weeks.ResultsAcceptability of OHP-CHR was demonstrated by high session attendance (<i>n</i> = 26; 86.7% attended all nine sessions) and participant satisfaction scores (CSQ-8: mean = 28.35, SD = 3.68). Feasibility of conducting a confirmatory clinical trial was supported by strong recruitment over 12 months (<i>n</i> = 30; rate of 2-3/month) high retention (<i>n</i> = 26; 86.7% at 12 weeks), intervention fidelity, and ease of completing the clinical assessment schedule. Preliminary indicators of clinical efficacy were demonstrated by a decrease in psychiatric symptoms, improvement in resilience, and enhanced functioning.ConclusionsOHP-CHR is a promising psychosocial intervention co-designed by CHR youth. Our data support the acceptability of the intervention, the feasibility of conducting a confirmatory clinical trial, and preliminary evidence of efficacy in improving clinical and functional outcomes.Trial is registered at ClinicalTrials.gov NCT05757128.Plain Language Summary TitleTesting a well-being and self-efficacy programme for Canadian youth at risk for psychosis.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"623-633"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629313","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":"One in Twenty: Prevalence and Outcomes of Patients Brought to EDs Under Québec's P-38 Mental Health Act-A Retrospective Cohort Study: Un patient sur vingt : prévalence et résultats chez les patients ayant été admis au service des urgences en vertu de la loi p-38 du Québec sur la santé mentale-Étude de cohorte rétrospective.","authors":"Marie-Soleil Dumont, Valérie Boucher, Pier-Alexandre Tardif, Ann-Pier Gagnon, Axel Benhamed, Pierre-Gilles Blanchard, Audrey-Anne Dumais-Michaud, Marcel Émond, Eric Mercier","doi":"10.1177/07067437261468893","DOIUrl":"10.1177/07067437261468893","url":null,"abstract":"<p><p>IntroductionIn Quebec, the P-38.001 Act (P-38) allows police officers or crisis workers, under exceptional circumstances, to bring individuals at risk of harming themselves or others to the Emergency Department (ED) against their will. Data on the application of this Act remains limited.ObjectivesWe aimed to determine the prevalence of P-38 use among ED patients with mental health presentations and to compare their characteristics, clinical course, and outcomes with those who sought care voluntarily.MethodsWe conducted a retrospective cohort study using a Public Health Agency of Canada-approved mental health database. Patients aged ≥14 years presenting to 5 EDs for mental health reasons in 2020-2021 were included. The main outcome, enforcement of P-38, was abstracted from medical charts. Information on care trajectory and management was also collected. Relative risks (RR) were estimated using modified Poisson regression with robust variance.ResultsAmong 15,021 mental health-related ED visits, 860 (5.7% [95% CI: 5.4-6.1]) involved enforcement of the P-38 Act. Mean age was 41.1 ± 16.5 years, with 46.1% aged 25-44, and 54.4% being male. Most lived independently (85.4%), arrived by ambulance (80.5%), and had a documented mental health history (92.2%). A higher proportion were materially deprived (<i>P</i> = 0.020). Compared with patients who voluntarily consulted in the ED, those under P-38 were more likely to be restrained (RR: 1.68 [95% CI: 1.45-1.94]), placed under preventive confinement (RR 3.41 [95% CI: 2.96-3.93]), receive multidisciplinary assessment (RR: 1.70 [95% CI: 1.59-1.80]), and be hospitalized (RR: 1.36 [95% CI: 1.24-1.48]).ConclusionEnforcement of P-38 accounted for nearly 6% of mental health-related ED visits, disproportionately affecting materially deprived individuals in early to mid-adulthood with prior mental health disorders. Our findings suggest a reliance on coercive and short-term measures, underscoring the need for targeted policy efforts to expand community-based crisis intervention alternatives for this vulnerable population.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261468893"},"PeriodicalIF":4.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594761","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":"Zero-Shot Large Language Models for Preliminary Prediction of PTSD Symptoms From Clinical Interview Transcripts: Grands modèles de langage sans exemple pour la prédiction préliminaire des symptômes de TSPT à partir de transcriptions d'entrevues cliniques.","authors":"Bazen Gashaw Teferra, Christian Kevin Sidharta, Wei-Ni Hsiang, Alice Rueda, Beier Guan, Yanbo Zhang, Lisa Burback, Olga Winkler, Andrew Greenshaw, Eric Vermetten, Rakesh Jetly, Jitendar Sareen, Ruth Lanius, Richard J Zeifman, Divya Sharma, Sri Krishnan, Candice Monson, Venkat Bhat","doi":"10.1177/07067437261468897","DOIUrl":"10.1177/07067437261468897","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundPosttraumatic stress disorder (PTSD) is common yet frequently underdiagnosed, in part due to barriers to systematic screening and the reliance on self-report instruments. Large language models (LLMs) have shown promise in extracting clinically relevant information from unstructured language, but their ability to infer item-level PTSD symptom severity from clinical interviews remains unclear.MethodsUsing the Distress Analysis Interview Corpus-Wizard of Oz (DAIC-WoZ), we analyzed 100 semi-structured clinical interview transcripts paired with item-level PTSD Checklist-Civilian Version (PCL-C) scores. Six LLMs (DeepSeek 3.1, Claude Sonnet 4, LLaMA 4 Scout, GPT-4o, GPT-5, and Gemini 2.5 Flash) used zero-shot prompting to predict all 17 PCL-C items. Performance was assessed for binary symptom endorsement (≥3 vs. &lt; 3), 5-point Likert prediction, and DSM-IV symptom-cluster analyses using accuracy, F1 score, and Matthews correlation coefficient (MCC).ResultsFor binary prediction, Claude 4 achieved the highest mean accuracy (0.705; 95% CI, 0.681-0.728), followed by DeepSeek 3.1(0.699; 95% CI, 0.675-0.724) and Gemini 2.5 (0.698; 95% CI, 0.677-0.718). For Likert prediction, DeepSeek 3.1 performed best (accuracy = 0.438; 95% CI, 0.401-0.475), only modestly above the majority-class baseline (0.399; 95% CI, 0.355-0.443). Performance varied by symptom domain, with re-experiencing and hyperarousal symptoms generally predicted more accurately than avoidance/numbing symptoms. Across models, predicted item-level symptom patterns showed a meaningful alignment with observed PCL-C responses despite reduced accuracy in fine-grained severity estimation.ConclusionZero-shot LLMs' performance was insufficient for clinical application in predicting PTSD symptoms from semi-structured interview transcripts. While models showed some ability to capture overall symptom patterns, performance varied across domains and remained limited for fine-grained severity estimation. Given these constraints and the non-trauma-specific nature of the dataset, findings should be interpreted as preliminary, with only modest differences observed between models.Plain Language Summary TitleCan Artificial Intelligence Identify PTSD Symptoms from Conversations? A Study Using Clinical Interview TranscriptsPlain Language SummaryPost-traumatic stress disorder (PTSD) is a common mental health condition, but it is often missed in clinical settings. Screening usually relies on questionnaires that patients must complete themselves, which may not always happen due to time, stigma, or discomfort discussing trauma. Researchers are exploring whether artificial intelligence (AI) could help identify PTSD symptoms from conversations instead.In this study, we tested several advanced AI systems, known as large language models, to see if they could estimate PTSD symptoms based on written transcripts of clinical interviews. These interviews were not specifically designed to assess trauma, which makes the","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261468897"},"PeriodicalIF":4.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537691","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 Post-Traumatic Stress Injuries Among Canadian Public Safety Communicators: A Nationwide Comparative Study: Prévalence des blessures de stress post-traumatique chez les communicateurs en sécurité publique canadiens : étude comparative nationale.","authors":"Steve Geoffrion, Constance Boulé, Filippo Rapisarda, Stephen Czarnuch, Rosemary Ricciardelli","doi":"10.1177/07067437261468881","DOIUrl":"10.1177/07067437261468881","url":null,"abstract":"<p><p>BackgroundPublic safety communicators (PSCs, 911 call-takers, dispatchers, and others) play a critical role in Canada's emergency response system, yet they remain largely understudied compared with other public safety professionals (PSP). Although PSCs do not intervene directly at emergency scenes, they are routinely exposed to potentially psychologically traumatic events and high operational stress during calls, placing them at elevated risk for post-traumatic stress injuries (PTSIs). This study aimed to (1) estimate the prevalence of various PTSIs and suicidal behaviors among Canadian PSCs, (2) compare the prevalence with those reported for other Canadian PSP, and (3) identify associated sociodemographic factors.MethodsThe final analytic sample included 508 PSCs. Participants completed validated screening measures assessing symptoms of post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, panic disorder, and alcohol use disorder, along with questions regarding suicidal behaviors.ResultsNearly half of PSCs (48.6%) screened positive for at least 1 PTSI, exceeding the prevalence observed among other Canadian PSP. Symptoms of PTSD, depression, anxiety, and panic disorder were significantly higher, while alcohol abuse disorder symptoms were comparable to levels observed among other PSP. Suicide attempts were also significantly more frequent in our sample. Being female emerged as the strongest predictor of screening positive for a PTSI, whereas higher educational attainment was associated with reduced odds of both PTSI symptoms and suicidal ideation.ConclusionsThese findings highlight PSCs as a high-risk and overlooked subgroup within public safety. Trauma-informed training, targeted organizational adjustments, and profession-specific support resources are essential to mitigate the significant psychological burden on this workforce and foster long-term occupational well-being.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261468881"},"PeriodicalIF":4.4,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498530","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":"Shared Views on Improving Community Treatment Orders: A Qualitative Study in Ontario: Points de vue communs sur l'amélioration des ordonnances de traitement communautaire : une étude qualitative réalisée en Ontario.","authors":"Sam Boyle, Fiona Jager, Jean-Laurent Domingue, Amélie Perron","doi":"10.1177/07067437261462694","DOIUrl":"10.1177/07067437261462694","url":null,"abstract":"<p><p>BackgroundPersons involved in compulsory mental health treatment-including clinicians, lawyers, service users, and family members-frequently express dissatisfaction with how the system is regulated and administered. Policy discussions on improving the system often fail to consider the voices of service users and family members. Policy development must also grapple with the contested values of autonomy and wellbeing, and the associated disjuncture in professional views. Community treatment orders (CTOs) are a key mechanism of compulsory mental health treatment in Ontario, and many other jurisdictions. We studied views on CTOs in Ontario to identify agreement across groups about where and how the system ought to be improved.MethodWe conducted semi-structured individual interviews followed by mixed focus groups including 72 participants: healthcare professionals, lawyers, tribunal members, service users (\"clients\"), family members, and advocates. Interview data were analyzed to identify recurring concerns and inform focus group discussion topics. Focus groups explored potential areas of alignment across participant groups, with particular attention to points of consensus. A lived-experience advisory panel informed study design.ResultsAcross participant groups, 6 main areas of agreement were visible. Participants identified the need for: (1) increased client involvement in treatment decisions, even within compulsory frameworks; (2) improved police involvement during CTO enforcement; (3) improved availability and quality of CTO-related data, enabling evaluation, accountability and attention to equity; (4) enhanced guidance and support for substitute decision-makers; (5) stronger oversight of medical decision-making, though preferred mechanisms varied; and (6) expanded community services-particularly housing, addiction treatment and case management-viewed as essential for CTOs to be able to have their intended benefit.ConclusionsThis study shows there is meaningful agreement on several areas requiring improvement in Ontario's CTO system. These points of convergence represent promising foundations for policy development, although translation into actionable reform will require further policy work.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261462694"},"PeriodicalIF":4.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450620","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}