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

{"title":"Monitoring Rates for Metabolic Syndrome in Adults Treated With Atypical Antipsychotics: A Population-Based Study in British Columbia: Fréquence de la surveillance du syndrome métabolique chez les adultes traités par des antipsychotiques atypiques : étude fondée sur la population menée en Colombie-Britannique.","authors":"Ridhwana Kaoser, M Ruth Lavergne, Sandra Peterson, Agnes Grudniewicz, Helen Thai, Lucie Langford, Rita K McCracken, Sara English, David Rudoler","doi":"10.1177/07067437261420884","DOIUrl":"10.1177/07067437261420884","url":null,"abstract":"<p><strong>Purpose: </strong>We examine the rate of recommended screening and monitoring practices for detecting metabolic changes following treatment with atypical antipsychotics, comparing data from the pre-pandemic and post-pandemic periods. We also compared the characteristics of adults who undergo screening tests with those who did not to identify underserved populations.</p><p><strong>Method: </strong>We use population-based administrative data from British Columbia, Canada, between 2018 and 2023 to describe the characteristics of adults who received or did not receive the laboratory test within recommended timeframes. To identify baseline screening tests, the cohort was stratified into antipsychotic-naïve and non-naïve groups. We describe the number and percentage of each lab test completed by patients, and the specialty of the ordering provider across different periods.</p><p><strong>Results: </strong>Over one-third of the population did not receive any recommended screening tests, and less than 15 per cent received baseline screening. Young adults aged 19 and 34 years were the least likely to undergo metabolic monitoring. Being older, having a greater number of chronic conditions, more primary care visits, and visits with the same provider resulted in better metabolic monitoring. Most screening tests were ordered by family physicians. Overall, screening practices worsened slightly in the post-pandemic period.</p><p><strong>Conclusion: </strong>Metabolic monitoring following treatment with atypical antipsychotics was lowest among young adults and adults newly initiated on atypical antipsychotics. Frequent primary care visits and continuity with the same providers resulted in improved screening.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"436-448"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196034","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":"Adjunctive Electroconvulsive Therapy for First Episode Mania: Data From a Tertiary Care Center in India: Électroconvulsivothérapie d'appoint en cas de premier épisode de trouble maniaque: Données provenant d'un centre de soins tertiaires en inde.","authors":"Nellai K Chithra, Pavithra Jayasankar, Shyam Sundar Kanagarajan, Karishma Kulkarni, Vijay Kumar, Muralidharan Kesavan, Lakshmi N Yatham","doi":"10.1177/07067437261430236","DOIUrl":"10.1177/07067437261430236","url":null,"abstract":"<p><strong>Background: </strong>First Episode Mania (FEM) in Bipolar 1 Disorder (BD-1) often presents as a psychiatric emergency requiring rapid symptom control. While electroconvulsive therapy (ECT) is recommended for severe or treatment-resistant mania, its role in FEM has not been well studied, particularly in India, where ECT is widely practiced. This study aimed to examine the indications, parameters, acute response, safety, and first recurrence outcomes associated with ECT in FEM.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of patients admitted with FEM at the National Institute of Mental Health and Neurosciences (NIMHANS), India, between 2008 and 2011. Of 213 patients with FEM, 81 (38%) received ECT along with pharmacotherapy; 63 with complete records were included in this study. Data on sociodemographic and clinical features, ECT parameters, indications, response, and recurrence were extracted. Response was defined as ≥ 75% improvement in manic symptoms, and remission as complete absence of symptoms for ≥ 8 weeks.</p><p><strong>Results: </strong>ECT was initiated within a mean of 8.7 days of admission, most often for aggression (66.7%), urgent need for improvement (51.6%), or augmentation of pharmacotherapy (27.4%). Patients received an average of 5-6 sessions, predominantly bitemporal (90.5%). Side effects were minimal, limited to transient oral injuries, prolonged seizures, or mild cognitive complaints in < 10%. Response was seen in 90.5%, with a mean time for remission of around 1 month. Among 45 patients with follow-up data, recurrence occurred in 24.4% within a year.</p><p><strong>Discussion: </strong>ECT was frequently used in FEM, driven by clinical severity and need for rapid response. It was found to be safe, and associated with high response rates. These findings suggest ECT may be a valuable early intervention in FEM, warranting prospective controlled studies.Plain Language Summary TitleCan Electroconvulsive therapy help in the First Episode of Mania?</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"458-466"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488719","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":"Effectiveness of Long-Acting Injectable Antipsychotics Versus Oral Antipsychotics in People With Bipolar Disorder: A Systematic Review and Meta-Analysis of Observational Studies: Efficacité des antipsychotiques injectables à action prolongée par rapport aux antipsychotiques oraux chez les personnes atteintes de troubles bipolaires : revue systématique et méta-analyse d'études observationnelles.","authors":"Elias Wagner, Saguna Katyal, In Ok Lee, Sabah Tasnim, Hajar El Wadia, Matin Mortazavi, Juan Antonio García-Carmona, Alkomiet Hasan, Ian Colman, Heidi Taipale, Jari Tiihonen, Christoph U Correll, Mikkel Højlund, Marco Solmi","doi":"10.1177/07067437251412576","DOIUrl":"10.1177/07067437251412576","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Randomised trials suggest long-acting injectable antipsychotics (LAIs) may outperform oral antipsychotics (OAPs) regarding adherence and relapse prevention in bipolar disorder (BD). We aimed to compare the effectiveness and tolerability of LAIs versus OAPs in observational studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Searching MEDLINE/Embase/PsycINFO until March-25-2025, we conducted a systematic review and random-effects meta-analysis (pre-registered protocol: https://osf.io/gkwrp) of observational studies comparing LAIs versus OAPs in people with BD (primary outcome = study-defined relapse/psychiatric hospitalisation).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventeen studies (4 = cohort, 13 = mirror-image studies; 6186/3676 participants with BD, respectively, high-quality per Newcastle-Ottawa Scale Score ≥7 = 47.1%) were included. The relative risk (RR) for study-defined relapse/psychiatric hospitalisation was significantly lower with LAIs versus OAPs in cohort (&lt;i&gt;k&lt;/i&gt; = 4, RR = 0.63, 95% confidence interval (CI) = 0.44;0.90, &lt;i&gt;P&lt;/i&gt; = 0.026) and mirror-image studies (&lt;i&gt;k&lt;/i&gt; = 5, RR = 0.46, 95% CI = 0.28;0.77, &lt;i&gt;P&lt;/i&gt; = 0.013). LAIs were not significantly superior to OAPs in high-quality cohort studies (&lt;i&gt;k&lt;/i&gt; = 3, &lt;i&gt;P&lt;/i&gt; = 0.78) but in those adjusted for &gt;5 factors (&lt;i&gt;k&lt;/i&gt; = 2, RR = 0.56, 95% CI = 0.37;0.84, &lt;i&gt;P&lt;/i&gt; = 0.006) nor in high-quality mirror-image studies (&lt;i&gt;k&lt;/i&gt; = 2, &lt;i&gt;P&lt;/i&gt; = 0.38), but in each second-generation antipsychotic-LAIs study (aripiprazole-LAI: &lt;i&gt;k&lt;/i&gt; = 2, risperidone-LAI: &lt;i&gt;k&lt;/i&gt; = 1) (&lt;i&gt;k&lt;/i&gt; = 3, RR = 0.40, 95% CI = 0.20;0.80, &lt;i&gt;P&lt;/i&gt; = 0.03). In cohort studies, LAIs and OAPs did not differ regarding psychiatric hospitalisations (&lt;i&gt;k&lt;/i&gt; = 3, &lt;i&gt;P&lt;/i&gt; = 0.078) but data on discontinuation and mortality risk were lacking/not meta-analysable. In mirror-image studies, LAIs were associated with significantly lower psychiatric (&lt;i&gt;k&lt;/i&gt; = 4, RR = 0.50, 95% CI = 0.25;0.99, &lt;i&gt;P&lt;/i&gt; = 0.048) and depression-related (&lt;i&gt;k&lt;/i&gt; = 2, RR = 0.46, 95% CI = 0.24;0.86, &lt;i&gt;P&lt;/i&gt; = 0.014), but not mania-related hospitalisation risk (&lt;i&gt;k&lt;/i&gt; = 2, &lt;i&gt;P&lt;/i&gt; = 0.075). LAIs were associated with fewer psychiatric hospitalisations (&lt;i&gt;k&lt;/i&gt; = 7, SMD = -1.73, 95% CI = -2.88;-0.57, &lt;i&gt;P&lt;/i&gt; = 0.011), hospitalisation days (&lt;i&gt;k&lt;/i&gt; = 9, SMD = -1.35, 95% CI = -2.19;-0.52, &lt;i&gt;P&lt;/i&gt; = 0.006), mania-related hospitalisations (&lt;i&gt;k&lt;/i&gt; = 3, SMD = -0.87, 95% CI = -1.19;-0.56, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and manic episodes (&lt;i&gt;k&lt;/i&gt; = 3, SMD = -1.13, 95% CI = -2.00;-0.26, &lt;i&gt;P&lt;/i&gt; = 0.03), but not any mood (&lt;i&gt;k&lt;/i&gt; = 4, &lt;i&gt;P&lt;/i&gt; = 0.13) or depressive episodes (&lt;i&gt;k&lt;/i&gt; = 3, &lt;i&gt;P&lt;/i&gt; = 0.14). Tolerability outcomes were missing, and GRADE certainty-of-evidence was &lt;i&gt;\"&lt;/i&gt;low\" to \"very low\".&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;LAIs were superior versus OAPs in preventing relapse/hospitalisation in cohort and mirror-image studies, in the latter particularly for mania-related outcomes. More robust mirror-image and controlled ","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"420-435"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094932","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":"When Mania Outruns the Law: Managing Risk in the Liminal Zone.","authors":"Kenya A Costa-Dookhan, Andrew Lustig","doi":"10.1177/07067437261433736","DOIUrl":"10.1177/07067437261433736","url":null,"abstract":"<p><p>Patients with mania are often acutely unwell yet do not meet criteria for involuntary hospitalization. This creates a clinical and ethical dilemma the authors refer to as the liminal zone. These patients refuse treatment despite clear foreseeable harms, but the legal threshold for certification is not met. This situation produces moral discomfort for clinicians, disrupts team consensus, and is often equally distressing for families and friends who recognize impending consequences but lack formal authority to intervene. This article outlines practical approaches for managing liminal-zone patients. First, values-based containment reframes hospitalization using the patient's own motivations. This involves focusing on the protection of their business, relationships, reputation, or other priorities, rather than emphasizing illness. Clinicians may also need to share factual information about regulatory obligations that could apply if safety concerns emerge. Early engagement of family or key supports helps maintain alignment and extends containment beyond the inpatient unit. Second, when discharge appears unavoidable, the focus shifts to preparing a soft landing. This includes arranging next-day outpatient follow-up, offering rapid readmission pathways, communicating clearly with community providers, and documenting the decision-making process. Documentation should outline why legal criteria were not met, the foreseeable risks, and the mitigation strategies that were attempted. Third, the liminal zone affects clinical teams. Manic symptoms fluctuate across short periods of time, which results in different team members observing different presentations. This variability can be mistaken for manipulation. Naming this pattern and acknowledging systemic constraints can help reduce tension and prevent burnout. Liminal-zone patients sit at the boundary between autonomy and safety. Effective management relies on clarity, consistency, and collaboration, with an emphasis on maintaining engagement and creating future opportunities for care.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"477-479"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500797","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":"Beyond RCTs-Better Research Designs and Methods for Psychosocial Efficacy Studies in Mental Health.","authors":"Tania Lecomte, Ian Raugh, Meryl Caiada, Mahesh Menon","doi":"10.1177/07067437261456381","DOIUrl":"10.1177/07067437261456381","url":null,"abstract":"<p><p>BackgroundClassic randomized controlled trials (RCTs) are considered the gold standard in mental health research but, given their multiple limitations and threats to external validity, alternative trial designs may be more suitable in many circumstances.ObjectivesThis narrative review explores research designs and methodologies that can be useful to researchers interested in investigating the effects of psychosocial or other non-medical interventions for psychiatric conditions.ResultsNew or better-tailored methods have been developed over the years, including: improved RCTs with adaptive designs (e.g., microRCT, SMART, RAR, target-emulation, adaptive dose-response), randomized baseline single case experimental designs; experience sampling method; E-technology (e.g., sensors for movement, social media monitoring with natural language processing); matched cohort studies and cluster randomized trials; and partially randomized preference trials, as well as mixed-methods and hybrid effectiveness/implementation trials.ConclusionBy expanding the scope of recommended methods, above and beyond classic RCTs, the field can more easily determine the impact of psychosocial treatments in mental health research.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261456381"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139822","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":"Toward a Standardized Suicide Risk Assessment in Psychotic Disorders: A Delphi Study With Mental Health Experts: Vers une évaluation standardisée du risque de suicide chez les personnes atteintes de troubles psychotiques : étude Delphi auprès d'experts en santé mentale.","authors":"Félix Diotte, Christine Genest, Hugo Thomas, Tania Lecomte","doi":"10.1177/07067437261425026","DOIUrl":"10.1177/07067437261425026","url":null,"abstract":"<p><strong>Background: </strong>Individuals with psychotic disorders face an elevated risk of suicide, yet current assessment tools often lack adaptations for this population's unique clinical realities. No standardized guidelines exist specifically for assessing suicide risk in psychosis, contributing to variability in clinical practice.</p><p><strong>Methods: </strong>A two-round Delphi survey was conducted with 42 professionals specializing in suicide prevention or psychotic disorders. Participants rated the relevance of 100 items related to suicide risk assessment and potential systemic facilitators. The top 35 items from the first round were retained for further prioritization in the second round. Descriptive statistics were used to analyze consensus levels.</p><p><strong>Results: </strong>Only eight out of 29 systemic factors received strong support, mostly related to the availability of practical tools and structural supports. Of the 71 risk assessment items, 35 surpassed the 4.25/5 relevance threshold. Highest consensus was found for items related to suicidal ideation and planning, such as intent, method, and access to means. Protective factors were also endorsed, while psychological/internal states (e.g., burdensomeness) were rated less relevant.</p><p><strong>Discussion: </strong>Findings underscore clinicians' emphasis on immediate risk and practical tools over abstract internal states. Results advocate for developing standardized, population-specific assessment protocols that balance risk and protective factors in individuals with a psychotic disorder.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"449-457"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345658","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":"Building a Sexual and Reproductive Health Module for Implementation in Early Psychosis Programs: A Co-creation Process: Création d'un module sur la santé sexuelle et reproductive à mettre en œuvre dans les programmes d'intervention précoce en cas de psychose : un processus de création conjointe.","authors":"Lucy C Barker, Juveria Zaheer, Robyn Wong-Lee, Hannah Kearney, Augustina Ampofo, Victoria Bodogh, Cheryl Dobinson, Robert Dmytryshyn, Sheila Dunn, George Foussias, Nicole Kozloff, June Sing Hong Lam, Ananka Rodriguez, Frank Sirotich, Sophie Soklaridis, Victoria Villanueva, Aristotle N Voineskos, Simone N Vigod","doi":"10.1177/07067437261420713","DOIUrl":"10.1177/07067437261420713","url":null,"abstract":"<p><strong>Background: </strong>Individuals with psychosis are at risk for adverse sexual and reproductive health (SRH) experiences, and for receiving suboptimal SRH care. Early psychosis intervention (EPI) programs offer an opportunity to address SRH early in the illness course, yet SRH is not currently part of routine EPI care. This project sought to develop a SRH module for women, transgender, and gender-diverse individuals for delivery within EPI care.</p><p><strong>Methods: </strong>To develop the SRH module, an integrated knowledge translation frame was used, informed by a community-based participatory action research approach. A working group was formed of diverse Youth Advisors (n = 3) and a Youth Engagement Specialist (n = 1) with lived experience with early psychosis, SRH experts (n = 3), mental health experts (n = 3), and research staff (n = 1). The working group met approximately biweekly to co-develop the module (January-October 2023). The module was formatted based on the NAVIGATE model of coordinated specialty care, and was informed by prior research on SRH and working group members' lived and clinical experiences.</p><p><strong>Results: </strong>The working group developed an interactive module covering five topics: (1) relationships, (2) sexual health, (3) reproductive health, (4) sexual orientation and gender identity, and (5) interpersonal violence. For each topic, client-facing materials (check-in questions, potential topics, worksheets) and clinician-facing materials (goals, handouts, suggested agendas, teaching strategies, tips for common challenges, evaluating gains and therapeutic goals, specific techniques, probes) were developed. SRH and mental health experts brought evidence-based content, and youth brought an affirming and youth-friendly lens to language and content.</p><p><strong>Conclusion: </strong>The developed module covers a broad array of SRH topics important to youth. If implementation is successful, the module could improve SRH-related well-being and outcomes for women, transgender, and gender-diverse youth with psychosis. Including youth with lived experience as collaborators enhanced inclusivity and relevance.Plain Language Summary TitleAddressing sexual and reproductive health for youth with early psychosis: description of a collaborative process to build a care module.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"467-476"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12916341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222131","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":"GLP-1 Receptor Agonists as a Novel Solution for Antipsychotic-Induced Weight Gain in Severe and Persistent Mental Illness.","authors":"Samantha Jacobson, Noah Margolese, Howard C Margolese","doi":"10.1177/07067437251386626","DOIUrl":"10.1177/07067437251386626","url":null,"abstract":"<p><p>Patients with severe and persistent mental illness (SPMI) experience significant metabolic side effects from antipsychotic medications, including antipsychotic-induced weight gain (AIWG). This contributes to a high prevalence of obesity, insulin resistance, and type 2 diabetes in this population, ultimately reducing life expectancy. Traditional weight management strategies, such as behavioural interventions, are often less feasible in this group. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for type 2 diabetes, have shown promise in addressing AIWG by reducing weight, improving metabolic parameters, and offering potential neuroprotective and psychiatric benefits. Evidence supports the efficacy of GLP-1RAs in managing AIWG, with studies demonstrating substantial reductions in weight and body mass index without exacerbating psychiatric symptoms. However, access to these medications remains limited due to high costs and restrictive healthcare policies. Expanding access to GLP-1RAs could bridge a critical gap in care for patients with SPMI, improving both physical and mental health outcomes. Future research should focus on evaluating long-term efficacy and cost-effectiveness, particularly in the Canadian healthcare context, to inform policy changes and optimize treatment strategies.Plain Language Summary TitleCan diabetes medications help treat weight gain caused by antipsychotics?</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"413-419"},"PeriodicalIF":3.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304531","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":"Cannabis Legalization Outcomes in Canada: Trading Off Increased Health Problem for Reduced Crime Burdens Is Not Good Enough.","authors":"Benedikt Fischer, Wayne Hall, Didier Jutras-Aswad, Bernard Le Foll, Daniel T Myran","doi":"10.1177/07067437261454772","DOIUrl":"10.1177/07067437261454772","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261454772"},"PeriodicalIF":4.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977409","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":"Acceptance and Commitment Therapy for the Parents of Children and Adolescents with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials: La thérapie d'acceptation et d'engagement pour les parents d'enfants et d'adolescents atteints de troubles du spectre de l'autisme : une revue systématique et une méta-analyse d'essais contrôlés à répartition aléatoire.","authors":"Abdullah M Alharran, Abdulrahman Hamad Aldousari, Shekha Alnajdi, Layal T Alwazzan, Munawer A Alsaid, Dana K Alkandari, Khaled Alsalem, Waleed Bader Alazemi","doi":"10.1177/07067437261450738","DOIUrl":"10.1177/07067437261450738","url":null,"abstract":"<p><p>BackgroundParents of children with autism spectrum disorder (ASD) experience significantly higher levels of stress, anxiety and depression. Acceptance and Commitment Therapy (ACT) has emerged as a promising intervention; however, the evidence remains inconsistent. This meta-analysis aims to evaluate the efficacy of ACT-based interventions in parents of children and adolescents with ASD.MethodsIn February 2026, we conducted a systematic search of PubMed, Scopus, Web of Science, Cochrane Library and Embase for randomized controlled trials (RCTs) assessing ACT-based interventions in parents of children/adolescents with ASD. For the meta-analysis, we used R software (version 4.5.0) with RStudio (2024.12.1 + 563) and the meta package.ResultsWe included seven RCTs with a total of 698 participants. Acceptance and Commitment Therapy significantly reduced parenting stress compared to control conditions, as measured by the Parenting Stress Index - Short Form Total Stress (mean difference [MD] = -7.05, 95 per cent CI -9.90 to -4.19, <i>p</i> < 0.0001, <i>I</i>² = 0 per cent), with consistent improvements across all subscales (Parental Distress, Parent-Child Dysfunctional Interaction and Difficult Child). Acceptance and Commitment Therapy also significantly improved psychological flexibility on the Acceptance and Action Questionnaire-II and Parenting Sense of Competence scale. For child outcomes assessed in our analysis, ACT significantly reduced total difficulties on the Strengths and Difficulties Questionnaire (MD = -2.80, 95 per cent CI -4.71 to -0.88, <i>P</i> = 0.004, <i>I</i>² = 0 per cent) and conduct problems (MD = -0.98, 95 per cent CI -1.62 to -0.33, <i>P</i> = 0.003, <i>I</i>² = 0 per cent).ConclusionAcceptance and Commitment Therapy-based interventions may be effective for reducing parenting stress, improving psychological flexibility, enhancing parenting competence and reducing child behavioural difficulties in parents of children with ASD. However, the limited number of studies and clinical heterogeneity might limit our findings, highlighting the need for future large-scale RCTs with longer follow-up.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261450738"},"PeriodicalIF":3.8,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977429","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}