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

{"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}

{"title":"A Tailored Approach to Care and Service Delivery for Women with Perinatal Mental Health Conditions-Commentary on the Canadian Network for Mood and Anxiety Treatments (CANMAT) 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety and Related Disorders.","authors":"Prabha S Chandra, Preethi V Reddy","doi":"10.1177/07067437251328248","DOIUrl":"10.1177/07067437251328248","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"493-495"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712214","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":"Ketamine and Perinatal Mental Health: Problems and Potentials.","authors":"Jennifer Swainson","doi":"10.1177/07067437251331514","DOIUrl":"10.1177/07067437251331514","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"496-498"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054534","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 Complex Journey of Women in Perinatal Psychiatric Care: Susceptibility to Illness Onset, Comorbidity and Clinical Trajectories: Le parcours complexe des femmes en psychiatrie périnatale : vulnérabilité, comorbidités et trajectoires cliniques.","authors":"Alexandra Painchaud, Marie-Josée Poulin, Célia Matte-Gagné, Chantal Mérette","doi":"10.1177/07067437251328347","DOIUrl":"10.1177/07067437251328347","url":null,"abstract":"<p><p>BackgroundMore than one in five women deal with a psychiatric disorder during the perinatal period. Whereas perinatal depression is well documented, there is still little research on the full range of perinatal psychiatric disorders and their clinical evolution across this whole period. The present study investigated the susceptibility to psychiatric illness during pregnancy and up to one year postpartum. We aimed to identify the most frequent disorders and comorbidities arising in each perinatal period. We outlined the clinical trajectories of these disorders in terms of evolution across past history, pregnancy and postpartum.MethodThrough a retrospective longitudinal design, data were collected in 2019-2020 from the medical records of the cohort of 964 women who required care in a tertiary perinatal psychiatry clinic located in Quebec City (Canada) between 2004 and 2020. Incidence rates of the full range of psychiatric disorders were estimated per period and their evolution across time identified clinical trajectories.ResultsDuring pregnancy, 34 different disorders were newly diagnosed with incidence rates ranging from 0.1% to 15.5% (45.6% of women having had at least one disorder diagnosed during pregnancy) whereas, during postpartum, 36 disorders were newly diagnosed with incidence rates ranging from 0.1% to 31.0% (67.5% of women having had at least one disorder diagnosed during postpartum). For most disorders, rates were significantly higher in postpartum than in pregnancy. A woman could develop multiple disorders during a given perinatal period: this comorbidity involved various combinations of diagnoses in 28% of women during pregnancy and 38% during postpartum. We outlined 52 different clinical trajectories from past history to postpartum, underlining the heterogeneity of the perinatal course.ConclusionsPregnancy is a susceptible period for women with past psychiatric histories whereas postpartum could trigger a new illness in women without a past history or pregnancy-onset psychiatric disorder.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"499-510"},"PeriodicalIF":3.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029707","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":"Peripheral Alzheimer's Disease Biomarkers Are Related to Change in Subjective Memory in Older Women with Cardiovascular Risk Factors in a Trial of Yoga vs. Memory Training: Lien établi entre les biomarqueurs périphériques de la maladie d'Alzheimer et l'amélioration de la mémoire subjective chez les femmes âgées présentant des facteurs de risque cardiovasculaire dans le cadre d'un essai comparant le yoga à l'entraînement de la mémoire.","authors":"Hanadi Ajam Oughli, Prabha Siddarth, Meachelle Lum, Lara Tang, Brandon Ito, Matthew Abikenari, Monica Cappelleti, Dharma S Khalsa, Sarah Nguyen, Helen Lavretsky","doi":"10.1177/07067437251343291","DOIUrl":"10.1177/07067437251343291","url":null,"abstract":"<p><strong>Objectives: </strong>Older women with cardiovascular risk factors and subjective memory complaints are at greater risk for Alzheimer’s disease (AD). We examined the changes in AD peripheral biomarkers, including phosphorylated-tau (p-tau), Aβ40, Aβ42, and Aβ42/40 ratio, in a randomized controlled trial of Kundalini yoga (KY) versus memory enhancement training (MET) in aging women at risk for AD.</p><p><strong>Methods: </strong>We recruited women (50+ years) with subjective memory complaints and high cardiovascular risk as defined by the ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Participants were randomized into KY versus MET, each lasting for 12 weeks, with a 24-week follow-up. We obtained blood samples at baseline and week 24 and measured Aβ 40, Aβ 42, and p-Tau. Participants completed the Memory Functioning Questionnaire (MFQ) to assess subjective memory at baseline and follow-up.</p><p><strong>Results: </strong>A total of 79 patients (KY = 40; MET = 39) were randomized, and biomarker data were available for 56 participants (KY = 24; MET = 32) at baseline and the 24-week follow-up. There were no group differences in AD biomarkers at baseline or at 24-week follow-up, and there were no significant changes in AD biomarkers from baseline to 24-week follow-up. Higher baseline levels of Aβ40 and Aβ42 were significantly associated with an improvement in subjective memory (MFQ Frequency of Forgetting and Seriousness of Forgetting) at follow-up. There was no significant association of the Aβ42/40 ratio and p-tau with changes in subjective memory.</p><p><strong>Conclusions: </strong>Our findings indicate that peripheral Aβ40 and Aβ42 levels are associated with improvement in memory self-awareness, particularly the reported frequency and perceived severity of forgetting. These levels may serve as potential biomarkers, reflecting underlying biological effects that could be utilized in future assessments. Further research is needed to determine how to successfully utilize peripheral biomarkers and subjective memory complaints to identify at-risk populations.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251343291"},"PeriodicalIF":3.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192484","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 Randomized Prospective Survey to Understand Readiness for Participation in Dementia Research Studies Across Diverse Communities: Une enquête prospective à répartition aléatoire visant à comprendre la disposition à participer à des études de recherche sur la démence dans diverses communautés.","authors":"Martha Sajatovic, Lynn Katherine Herrmann, Clara Knebusch, Nicole Fiorelli, Joy Yala, David Silva, Alan J Lerner, Edna Fuentes-Casiano, Christopher J Burant","doi":"10.1177/07067437251343294","DOIUrl":"10.1177/07067437251343294","url":null,"abstract":"<p><strong>Objective: </strong>Even with recruitment efforts for racial and ethnic minorities in dementia research, there is still underrepresentation in these communities. Targeting barriers and facilitators to research participation, we developed and tested a culturally tailored communication approach tailored for Hispanics.</p><p><strong>Methods: </strong>An iterative process informed by input from the minority advisory board of an Alzheimer's Disease Research Center, developed 2 brief health communication videos, featuring Hispanic actors/Spanish language sub-titles. The experimental video (POWER) focused on barriers, facilitators, and readiness to participate in dementia research. The control video focused on education only. A randomized prospective survey compared POWER vs. control. While race or ethnicity were not inclusion criteria for enrollment, we oversampled Hispanic and non-white communities. We examined change pre- vs. post-video on dementia knowledge, cumulative barriers, and facilitators to research participation, as well as change in research readiness measured by the Transtheoretical behavior change model.</p><p><strong>Results: </strong>The analyzable sample (N = 184) had a mean age of 40.0 (SD = 13.2) years, 57.4% (n = 105) female, 47.2% (n = 85) non-white, 21.2% (n = 39) Hispanic, with 88 individuals randomized to POWER and 96 to control. Unadjusted evaluation of change from pre- vs. post-video showed significant improvements in dementia knowledge, research facilitators and research barriers (all ps < .001) but no significant difference between POWER vs. controls. Adjusted for age, gender, race, ethnicity and education, only change in dementia knowledge remained significantly improved for the group as a whole, with no significant difference between POWER vs. controls. In the entire sample, Hispanics had significantly more improvement in research readiness (r = .217, p = .003). Exploratory analysis of positive change predictors in those randomized to POWER and to control suggests Hispanics in POWER may be at a disadvantage with respect to dementia knowledge (r = −.248, p = .02) and research facilitators (r = −.342, p = .001).</p><p><strong>Conclusions: </strong>Health communications can improve dementia knowledge across diverse communities.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251343294"},"PeriodicalIF":3.8,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144533","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 Longitudinal Study of the Relationship Among Cognition, Mood Symptoms, and Markers of Brain Health in Older Age Bipolar Disorder: Une étude longitudinale de la relation entre la cognition, les symptômes thymiques, et les marqueurs de la santé du cerveau en présence de troubles bipolaires du sujet âgé.","authors":"Ariel G Gildengers, Meryl A Butters, Howard J Aizenstein, James Emanuel, Tianyu Ding, Stewart J Anderson, James T Becker, Oscar Lopez, Charles F Reynolds, Benoit H Mulsant","doi":"10.1177/07067437251343295","DOIUrl":"10.1177/07067437251343295","url":null,"abstract":"<p><strong>Objectives: </strong>An emerging literature has assessed cognition or imaging markers of brain health in in older age bipolar disorder (OABD). In this context, we conducted the first longitudinal study (to our knowledge) that assessed the relationship among cognition, mood symptoms, and imaging markers of brain health in OABD.</p><p><strong>Methods: </strong>99 participants with OABD were enrolled, underwent baseline assessment, and were followed annually for up to 3 years. They completed comprehensive assessments that included evaluation of general medical status, vascular disease burden, mental status, cognitive performance. A subset of participants (n = 58) completed magnetic resonance imaging (MRI) at one or two time-points, yielding three measures of brain health: gray matter volume, fractional anisotropy (FA), and burden of white matter hyperintensities (WMH).</p><p><strong>Results: </strong>Group-based trajectory modelling (GBTM) of overall cognitive performance revealed two groups: a group with higher cognitive performance (63 of 99, 63.6%) and a group with lower cognitive performance (36 of 99, 36.4%). GBTM also revealed two groups based on each of the three imaging markers of brain health. The higher cognitive performance group was associated with the groups with higher measure of total gray matter or higher FA. We found no relationship between the cognitive groups and level of mood symptoms during longitudinal follow-up or WMH burden.</p><p><strong>Conclusions: </strong>In this first longitudinal study of cognition, mood symptoms, and markers of brain health in OABD, cognitive performance was related to brain health and not to mood symptoms over a follow-up of up to three years. Almost two-thirds of participants with OABD had cognitive performance comparable to older adults without OABD. Larger future studies will need to replicate and extend these findings.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251343295"},"PeriodicalIF":3.8,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144532","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":"Morbidity, Suicidal Ideation and Suicide Attempts Among Youth in Canada: A Nationally-Representative Study: Morbidité, idées suicidaires et tentatives de suicide chez les jeunes au Canada : Une étude représentative à l'échelle nationale.","authors":"Danielle Fearon, Alex Luther, Dillon Browne, Ian Colman, Joel A Dubin, Laura Duncan, Mark A Ferro","doi":"10.1177/07067437251343292","DOIUrl":"10.1177/07067437251343292","url":null,"abstract":"<p><strong>Background: </strong>Suicide is a leading cause of mortality among youth globally. Evidence suggests that individuals with physical illness, mental illness, or neurodevelopmental disorders are at increased risk of suicide. However, few studies have estimated the prevalence of suicidal ideation and suicide attempts among youth with compounding health burdens. The purpose of this study is to estimate the prevalence of suicidal ideation and suicide attempts and their associations across morbidity status among youth in Canada.</p><p><strong>Methods: </strong>Data come from 6,915 youth aged 15–17 years (49% female) enrolled in the 2019 Canadian Health Survey on Children and Youth. The person most knowledgeable or the youth themselves provided responses regarding sociodemographic characteristics, morbidity status, and indicators of suicide. The prevalence of suicidal ideation (past year) and suicide attempts (lifetime) were compared across morbidities (none, physical illness only, mental illness only, neurodevelopmental disorder only, and multimorbidity). Logistic regression models estimated adjusted associations between morbidity status and suicidal behaviour.</p><p><strong>Results: </strong>Suicidal ideation and suicide attempts were most commonly reported by youth with mental illness only (32%, 18%) and multimorbidity (28%, 19%). While all morbidities were associated with indicators of suicide, the strongest association was found between multimorbidity and suicide attempts odds ratio = 5.2 (3.4, 8.0).</p><p><strong>Conclusions: </strong>These contemporary estimates of youth in Canada suggest that suicidal ideation and suicide attempts are common and reinforce the need for integrated physical and mental health services for youth with multimorbidity to reduce the incidence. Research investigating causal mechanisms of the intersections between physical illness, mental illness, neurodevelopmental disorders, and suicide is needed.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251343292"},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121412","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 Use and Misuse of Over-the-Counter Melatonin in Children and Adolescents: A Commentary.","authors":"Chris Y Kim, Persis Yousef, Royi Gilad, Colin M Shapiro","doi":"10.1177/07067437251340683","DOIUrl":"10.1177/07067437251340683","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437251340683"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113134","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}