Kamyar Keramatian, Alexander Levit, Heeva Chavoshi-Nejad, Clara Westwell-Roper, John-Jose Nunez, Ashley Forbes, Emma Morton, Erin E Michalak, Eduard Vieta, Lakshmi N Yatham
{"title":"Early Psychoeducational Intervention for Youth and Young Adults at Risk for Bipolar Disorder: A Feasibility Study: Intervention psychoéducative précoce pour les adolescents et les jeunes adultes à risque de trouble bipolaire : Une étude de faisabilité.","authors":"Kamyar Keramatian, Alexander Levit, Heeva Chavoshi-Nejad, Clara Westwell-Roper, John-Jose Nunez, Ashley Forbes, Emma Morton, Erin E Michalak, Eduard Vieta, Lakshmi N Yatham","doi":"10.1177/07067437251342278","DOIUrl":"10.1177/07067437251342278","url":null,"abstract":"<p><strong>Objective: </strong>Bipolar disorder (BD) often goes unrecognized and untreated for several years leading to serious consequences. We have recently developed a manualized telehealth-based group psychoeducational and resilience enhancement program for individuals at high risk for bipolar disorder (PREP-BD). The primary objective of this study was to assess the feasibility of implementing PREP-BD to enhance help-seeking intentions among high-risk individuals.</p><p><strong>Method: </strong>The intervention consisted of eight weekly, 60-minute group psychoeducation sessions conducted via Zoom. Participants (N = 21), aged 17 to 24 years, who met the bipolar at-risk criteria, were assigned to one of four cohorts. Primary outcomes for this feasibility trial included sign-up rate, completion rate, and acceptability as measured by the Client Satisfaction Questionnaire (CSQ-8). Preliminary efficacy was assessed using validated measures of help-seeking intentions, resilience, quality of life, and stigma, with pre- and post-intervention comparisons.</p><p><strong>Results: </strong>Our findings indicate excellent feasibility as evidenced by timely recruitment, 100% sign-up rate, and 76.19% completion rate (defined as attending at least 75% of group sessions). The intervention showed preliminary improvements in help-seeking intentions, particularly for a hypomanic scenario. Quality of life also demonstrated significant improvement, while resilience and self-stigma showed non-significant trends toward improvement.</p><p><strong>Conclusion: </strong>Our findings suggest the feasibility of implementing psychoeducation as an early identification strategy in individuals at risk for BD. Future randomized controlled trials are needed to investigate the effectiveness of PREP-BD.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251342278"},"PeriodicalIF":3.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103242","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}
Haider Asadullah, Sabahat Ul Ain Munir Abbasi, Rayyan Nabi
{"title":"Integrating Mental Health in Perioperative Care: Addressing the Overlooked Impact of Chronic Stress and Depression on Surgical Outcomes.","authors":"Haider Asadullah, Sabahat Ul Ain Munir Abbasi, Rayyan Nabi","doi":"10.1177/07067437251340667","DOIUrl":"10.1177/07067437251340667","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251340667"},"PeriodicalIF":3.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103251","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}
Farooq Naeem, Muhammad Ishrat Husain, Muhammad Omair Husain, Baldev Mutta, Gary Thandi, Azaad Kassam, Maureen Abbott, Marcos Sanches, Helen-Maria Vasiliadis, Saeed Farooq, Kwame McKenzie
{"title":"Feasibility and Acceptability of Online Culturally Adapted Cognitive Behavioural Therapy for Depression and Anxiety in Canadians of South Asian Origin: A Randomized Controlled Trial: Faisabilité et acceptabilité de la thérapie cognitivo-comportementale en ligne adaptée à la culture pour traiter la dépression et l'anxiété chez les Canadiens d'origine sud-asiatique : Essai contrôlé à répartition aléatoire.","authors":"Farooq Naeem, Muhammad Ishrat Husain, Muhammad Omair Husain, Baldev Mutta, Gary Thandi, Azaad Kassam, Maureen Abbott, Marcos Sanches, Helen-Maria Vasiliadis, Saeed Farooq, Kwame McKenzie","doi":"10.1177/07067437251337644","DOIUrl":"10.1177/07067437251337644","url":null,"abstract":"<p><p>BackgroundThis paper reports a pilot trial of culturally adapted CBT (CaCBT) for Canadian South Asians. The primary objective of this study was to assess the feasibility and acceptability of online CaCBT to treat anxiety and depression in Canadian South Asian individuals. The secondary objective was to measure changes in depression, anxiety, and disability.MethodsAn assessor-blind randomized clinical trial was conducted at 3 sites in Canada (Greater Toronto Area, Ottawa, and Vancouver). One hundred forty-six participants were randomly allocated to 1 of 2 groups: Ca-CBT (experimental group) or standard cognitive behavioural therapy (CBT) (control group) in a 1:1 ratio. The primary outcome, feasibility, was measured through engagement, recruitment, and participant retention. Acceptability was measured through the Verona Service Satisfaction Scale. Working Alliance Inventory was used to measure therapeutic engagement. Secondary outcomes included depression (Hospital Anxiety and Depression Scale-HADS), somatic symptoms (Bradford Somatic Inventory-BSI), and disability (WHO Disability Assessment Schedule 2.0 (WHODAS). Assessments were carried out at baseline, at the end of therapy (12 weeks from baseline), and at follow-up (36 weeks from baseline).ResultsWe were able to recruit participants within the given timeframe with excellent retention rates in both arms. Most participants in the intervention group, 56 (74.7%), attended ≥ 8 sessions, and 11 (14.7%) attended 5 to 7 sessions. Eight (10.7%) participants from the intervention group and 9 (12.0%) from the control group dropped out of therapy (<5 sessions). Participants in the intervention group reported higher levels of satisfaction (<i>P</i> = 0.001) and therapeutic engagement (<i>P</i> < 0.001) compared with the control group. Participants in both groups benefited from CBT.ConclusionsThis is the first report of online CaCBT for depression and anxiety for Canadian South Asians. The intervention is acceptable and feasible. Culturally adapted CBT is as effective as standard CBT in reducing the symptoms of depression and anxiety.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251337644"},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082223","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 Implementation of Integrated Youth Services in Canada: Planning and Costing of a Pan-Canadian Model: La mise en œuvre des services intégrés pour les jeunes au Canada : planification et établissement des coûts d'un modèle pancanadien.","authors":"Jo L Henderson, Claire de Oliveira, Steve Mathias","doi":"10.1177/07067437241301008","DOIUrl":"10.1177/07067437241301008","url":null,"abstract":"<p><p>ObjectiveThe implementation of Integrated Youth Services (IYS) can help ensure that youth are adequately supported. The objective of this analysis was to provide a model for the planning and costing of IYS throughout Canada over a 15-year period.MethodsTo estimate resource allocation for IYS, we determined the number of hubs and hub staffing requirements by service level and jurisdiction, backbone support and infrastructure requirements by jurisdiction. A needs-based analytic framework for planning was employed to estimate the number of hubs required. The optimal mix of hub staffing requirements was determined based on prior literature. The costs of running each hub were estimated using publicly available data and internal documents from existing IYS agencies. Finally, the cost of setting up IYS hubs, IYS virtual care and respective backbone support throughout Canada was estimated and projected over 15 years and the cost-savings of IYS were calculated.ResultsAt maturity, it was estimated that 399 hubs-188 small, 43 medium, 168 large-across Canada would be required to address youth mental health and substance use needs. The cost of implementing IYS initiatives across Canada would vary between $4,349,126 (for less populous jurisdictions) and $248,950,524 (for more populous jurisdictions), for a total annual cost of $676,633,388 (excluding costs of infrastructure). It was estimated that the implementation of IYS hubs would lead to cost-savings of $2.1 billion annually and have the potential to be cost-effective.ConclusionThe implementation of IYS hubs can provide good value for money, in the form of high client satisfaction, earlier supports with improved youth outcomes and decreased health care costs. Future work should address gaps in data availability on mental health and substance use-related needs of youth with neurodevelopmental disorders, youth experiencing homelessness, youth in congregate living and foster care, and Indigenous youth.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"414-422"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803423","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><p>ObjectiveStimulant 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.MethodThe 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.Results<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.ConclusionsThe 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.Plain Language TitleAntipsychotic use in children previously diagnosed for ADHD and treated with stimulant medication.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"382-391"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","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}
{"title":"Strengthening Mental Health Services for Children and Youth in Canada.","authors":"Rachel H B Mitchell, Stephanie H Ameis","doi":"10.1177/07067437251346090","DOIUrl":"10.1177/07067437251346090","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"341-346"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217654","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}
Tyler Marshall, Matthew Reeson, Alexandra Loverock, Ariana E Lewis, Ian King, Raffay Ilyas, Celine Caruso Dixon, Dylan Viste, Brandon Azer, Ethan Chow, Fahad Safi, Megan Kennedy, Adam Abba-Aji, Andrew J Greenshaw
{"title":"Evidence-based Interventions for Youth With Concurrent Mental Health and Substance Use Disorders: A Scoping Review: Interventions fondées sur des données probantes pour les jeunes atteints de troubles concomitants de santé mentale et liés à l'usage de substances psychoactives : une étude de la portée.","authors":"Tyler Marshall, Matthew Reeson, Alexandra Loverock, Ariana E Lewis, Ian King, Raffay Ilyas, Celine Caruso Dixon, Dylan Viste, Brandon Azer, Ethan Chow, Fahad Safi, Megan Kennedy, Adam Abba-Aji, Andrew J Greenshaw","doi":"10.1177/07067437241300957","DOIUrl":"10.1177/07067437241300957","url":null,"abstract":"<p><p>BackgroundMental health and substance use disorders typically onset during youth and commonly co-occur. Integrated treatment of two or more co-existing mental health and substance use disorders (i.e., concurrent disorders) is increasingly prevalent in real-world clinical settings. However, the depth of the evidence base on best practices remains unclear.ObjectivesThis scoping review aimed to identify, map and summarize peer-reviewed studies of interventions for concurrent disorders in youth.MethodsSix electronic health databases were systematically searched, in addition to a hand search of the reference lists of relevant systematic reviews. Only peer-reviewed studies of interventions treating concurrent disorders (i.e., simultaneous treatment of two or more disorders) in youth (10-29 years old) were eligible. Two independent reviewers conducted screening and data extraction. Results were charted according to studies employing pharmacological and non-pharmacological interventions.ResultsThirty peer-reviewed studies were included, 19 (63.3%) were randomized controlled trials (RCTs). Most studies enrolled participants with an unspecified substance use disorder (n=17, 56.7%), while alcohol use was the primary substance use disorder in seven (23.3%) studies, followed by cannabis use disorder in six (20.0%) studies. Mood disorders (e.g., depression, dysthymia) were the most common concurrent mental health disorders comprising 15 (50%) studies, followed by nine (30.0%) studies of behavioural disorders (e.g., ADHD) and five (16.7%) studies of unspecified psychiatric disorders. Eighteen (60.0%) studies (n=1,699 participants) investigated the effectiveness of various non-pharmacological interventions, while 12 (40.0%) studies examined pharmacotherapies (n=765 participants).ConclusionAlthough several RCTs were identified, substantial clinical and methodological heterogeneity was evident among the studies (e.g., patients with multiple disorders, and multi-faceted interventions). Smaller systematic reviews focused on specific interventions (e.g., behavioural therapies) and concurrent disorders (e.g., depression and substance use) may be warranted. Due to considerable heterogeneity, more RCTs are needed before conducting larger systematic reviews or meta-analyses.Plain Language Summary TitleEvidence-based interventions for youth with concurrent mental health and substance use disorders: A scoping review.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"347-371"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958770","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":"Predictors of Depressive Symptoms in Autistic Youth-A Longitudinal Study From the Province of Ontario Neurodevelopmental Disorders (POND) Network: Prédicteurs des symptômes dépressifs chez les jeunes autistes-une étude longitudinale du Réseau des troubles neurodéveloppementaux de la province de l'Ontario (réseau POND).","authors":"Avery Longmore, Evdokia Anagnostou, Stelios Georgiages, Jessica Jones, Elizabeth Kelley, Danielle Baribeau","doi":"10.1177/07067437241259925","DOIUrl":"10.1177/07067437241259925","url":null,"abstract":"<p><p>ObjectiveThe objective of this study was to identify longitudinal predictors of depressive symptoms in autistic children and youth.MethodsParticipants were youth with a diagnosis of autism who were part of the Province of Ontario Neurodevelopmental Disorders Network longitudinal substudy. Depressive symptoms were assessed using the child behaviour checklist (CBCL) affective problems subscale. Univariate and multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between clinical and demographic characteristics at baseline (T1) and clinically elevated depressive symptoms (CEDS) approximately 4 years later (T2).ResultsThe mean age of participants (<i>n</i> = 75) at T1 was 9.8 years (<i>SD</i> = 2.7) and at T2 was 14.1 years (<i>SD</i> = 2.8). A total of 37% and 35% of participants had CEDS at T1 and T2, respectively. Additionally, 24% of participants had CEDS at both T1 and T2. T1 characteristics associated with T2 CEDS were: loneliness (OR = 3.0, 95% CI, 1.1 to 8.8), self-harm (OR = 4.0, 95% CI, 1.1 to 16.9), suicidal ideation (OR = 3.9, 95% CI, 1.0 to 16.5), more social and adaptive skills (OR = 0.3, 95% CI, 0.1 to 0.9), elevated restricted and repetitive behaviours (OR = 3.8, 95% CI, 1.3 to 11.6), psychotropic medication use (OR = 3.0, 95% CI, 1.1 to 8.4), attention-deficient/hyperactivity disorder (OR = 2.8, 95% CI, 1.1 to 7.8), and T1 CEDS (OR = 8.8, 95% CI, 3.1 to 27.0) (uncorrected for multiple comparisons). Associations persisted after adjusting for age and intelligence quotient (IQ) differences. Age, sex, IQ, teasing/bullying on the CBCL, family psychiatric history and family income were not associated with T2 CEDS.ConclusionOur results highlight both high prevalence and high potential for the persistence of depressive symptoms in autism and emphasize the importance of early support to address loneliness and social participation.Plain Language Summary TitleStudy assessing risk factors for depression in autistic youth.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"372-381"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762840","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}
Nicole G Hammond, Christopher Gravel, Mark A Ferro, Hannah Landry, Marie-Claude Geoffroy, Nicole Racine, Ian Colman
{"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><p>BackgroundFew 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.MethodsWe 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.ResultsA 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.ConclusionWe 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":"404-413"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","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}
Lee Propp, Hajer Nakua, Anne-Claude V Bedard, Marcos Sanches, Stephanie H Ameis, Brendan F Andrade
{"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><p>ObjectivesChildren 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.MethodsWe 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.ResultsLower 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.ConclusionsThe 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.Plain Language Summary TitleFrontal cortical thickness and externalizing psychopathology are associated with treatment outcomes in children with externalizing problems.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"392-403"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","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}