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    5644 results match your criteria Canadian journal of psychiatry. Revue canadienne de psychiatrie[Journal]

    1 OF 113

    The Standardization of Diagnostic Criteria for Fetal Alcohol Spectrum Disorder (FASD): Implications for Research, Clinical Practice and Population Health.
    Can J Psychiatry 2018 Jan 1:706743718777398. Epub 2018 Jan 1.
    1 Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.
    Objective: Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol consumption and marked by a range of physical and mental disabilities. Although recognized by the scientific and medical community as a clinical disorder, no internationally standardized diagnostic tool yet exists for FASD.

    Methods And Results: This review seeks to analyse the discrepancies in existing diagnostic tools for FASD, and the repercussions these differences have on research, public health, and government policy. Read More

    Movement Disorders Associated With Antipsychotic Medication in People With Schizophrenia: An Overview of Cochrane Reviews and Meta-Analysis.
    Can J Psychiatry 2018 Jan 1:706743718777392. Epub 2018 Jan 1.
    1 Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
    Movement disorders associated with antipsychotic medications are relatively common, stigmatising, and potentially disabling. Their prevalence in people with psychosis who are prescribed second-generation antipsychotics (SGAs) is uncertain, as is their level of recognition by clinicinas. We conducted meta-analyses of randomised controlled trials included in the Cochrane Database of Systematic Reviews on schizophrenia and schizophrenia-like psychoses to estimate the prevalence of new-onset dystonia, akathisia, parkinsonism, and tremor with SGAs (amisulpride, asenapine, aripiprazole, clozapine, olanzapine, paliperidone, quetiapine, risperidone, L-sulpiride, and ziprasidone) approved in Canada and the UK, comparing them with haloperidol and chlorpromazine. Read More

    An Overview of Animal Models Related to Schizophrenia.
    Can J Psychiatry 2018 Jan 1:706743718773728. Epub 2018 Jan 1.
    8 Department of Physiology, University of Saskatchewan, Saskatoon, Saskatchewan.
    Schizophrenia is a heterogeneous psychiatric disorder that is poorly treated with current therapies. In this brief review, we provide an update regarding the use of animal models to study schizophrenia in an attempt to understand its aetiology and develop novel therapeutic strategies. Tremendous progress has been made developing and validating rodent models that replicate the aetiologies, brain pathologies, and behavioural abnormalities associated with schizophrenia in humans. Read More

    Associations between Depression and Health Behaviour Change: Findings from 8 Cycles of the Canadian Community Health Survey.
    Can J Psychiatry 2018 Jan 1:706743718772523. Epub 2018 Jan 1.
    1 School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario.
    Objectives: The primary objective of this study was to examine associations between depression and several measures of health behaviour change across 8 cycles of a population-based, cross-sectional survey of Canadians. The secondary objective of this study was to describe the prevalence of the types of health behaviour changes undergone/sought and types of barriers to change reported, comparing those with and without depression.

    Methods: The sample comprised 65,801 respondents to the Canadian Community Health Survey between 2007 and 2014. Read More

    Cross-Cultural Psychometric Properties of the Hamilton Depression Rating Scale.
    Can J Psychiatry 2018 Jan 1:706743718772516. Epub 2018 Jan 1.
    1 Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen, Denmark.
    Objective: The Hamilton Depression Rating Scale (HDRS) is considered the gold standard measure of depression. The factor structure of the HDRS is generally unstable, but 4 to 8 items appear to form a general depression factor. As transcultural studies of the HDRS have received little attention, and as most of the studies have taken a data-driven approach with a tendency to yield fragmented results, it is not clear if an HDRS general depression factor can also be found in non-Western populations. Read More

    Bridging Hospital and Community Care for Homeless Adults with Mental Health Needs: Outcomes of a Brief Interdisciplinary Intervention.
    Can J Psychiatry 2018 Jan 1:706743718772539. Epub 2018 Jan 1.
    2 Department of Psychiatry, University of Toronto, Toronto, Ontario.
    Objective: This study examines health and service use outcomes and associated factors among homeless adults participating in a brief interdisciplinary intervention following discharge from hospital.

    Method: Using a pre-post cohort design, 223 homeless adults with mental health needs were enrolled in the Coordinated Access to Care for the Homeless (CATCH) program, a 4- to 6-month interdisciplinary intervention offering case management, peer support, access to primary psychiatric care, and supplementary community services. Study participants were interviewed at program entry and at 3- and 6-month follow-up visits and assessed for health status, acute care service use, housing outcomes, mental health, substance use, quality of life, and their working alliance with service providers. Read More

    Approved and Off-Label Use of Prescribed Psychotropic Medications among Federal Canadian Inmates.
    Can J Psychiatry 2018 Jan 1:706743718773734. Epub 2018 Jan 1.
    4 National Pharmacist, Correctional Service Canada, Ottawa, Ontario, Canada.
    Objective: To examine psychotropic medication prescription practices in federal Canadian penitentiaries.

    Method: 468 files were drawn from a purposive sample of thirteen Canadian federal institutions representing the five regions, different security levels, and male and female designated facilities. Information on the names of all psychotropic medications prescribed, indications for use, dosage, frequency, and route of administration was retrieved. Read More

    The Assessment and Treatment of Antipsychotic-Induced Akathisia.
    Can J Psychiatry 2018 Jan 1:706743718760288. Epub 2018 Jan 1.
    12 Department of Psychiatry, Imperial College London, London, UK.
    Akathisia is a common and distressing neuropsychiatric syndrome associated with antipsychotic medication, characterised by subjective and objective psychomotor restlessness. The goal of this guideline is to provide clinicians with recommendations on the assessment and treatment of akathisia. We performed a systematic review of therapeutic studies assessing the treatment of antipsychotic-induced extrapyramidal symptoms. Read More

    Can Animal Models Inform on the Relationship between Depression and Alzheimer Disease?
    Can J Psychiatry 2018 Jan 1:706743718772514. Epub 2018 Jan 1.
    1 Cell Signalling Laboratory, Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
    The focus on the β-amyloid (Aβ) peptide in clinical Alzheimer disease (AD) as well as in animal models of AD has perhaps biased our understanding of what contributes to the heterogeneity in disease onset and progression. Part of this heterogeneity could reflect the various neuropsychiatric risk factors that present with common symptomatology and can predispose the brain to AD-like changes. One such risk factor is depression. Read More

    Age of Cannabis Use Onset and Adult Drug Abuse Symptoms: A Prospective Study of Common Risk Factors and Indirect Effects.
    Can J Psychiatry 2018 Jan 1:706743718760289. Epub 2018 Jan 1.
    2 CHU Sainte-Justine Hospital Research Centre, Montreal, Quebec, Canada.
    The present study examined 1) whether the associations between cannabis use (CU) age of onset and drug abuse by 28 y remain when controlling for risk factors in childhood, adolescence and early adulthood; and 2) the developmental pathways from early risk factors to drug abuse problems. Participants from a longitudinal sample of boys of low socioeconomic status ( N = 1,030) were followed from 6 to 28 y. We examined the self-reported CU onset between the ages of 13 and 17 y and drug abuse symptoms by 28 y. Read More

    Beyond Silence: A Randomized, Parallel-Group Trial Exploring the Impact of Workplace Mental Health Literacy Training with Healthcare Employees.
    Can J Psychiatry 2018 Jan 1:706743718766051. Epub 2018 Jan 1.
    7 Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
    Objective: This study sought to evaluate whether a contact-based workplace education program was more effective than standard mental health literacy training in promoting early intervention and support for healthcare employees with mental health issues.

    Method: A parallel-group, randomised trial was conducted with employees in 2 multi-site Ontario hospitals with the evaluators blinded to the groups. Participants were randomly assigned to 1 of 2 group-based education programs: Beyond Silence (comprising 6 in-person, 2-h sessions plus 5 online sessions co-led by employees who personally experienced mental health issues) or Mental Health First Aid (a standardised 2-day training program led by a trained facilitator). Read More

    Dual Diagnosis: A Problematic Construct When Applied to Persons with Intellectual Disabilities.
    Can J Psychiatry 2018 Jan 1:706743718772515. Epub 2018 Jan 1.
    1 Children's Hospital of Eastern Ontario-Research Institute and the University of Ottawa, Ottawa, Ontario, Canada.
    The term dual diagnosis can refer to the co-occurrence of an intellectual disability and a mental disorder. While such a term may have some advocacy rationale aimed at facilitating improved mental health care for those with intellectual disabilities, it is proposed that the construct has flawed underpinnings, and its application may problematize mental health service delivery. A core concern is the promotion of categorical diagnostic models, whereas dimensional models may more accurately reflect underlying continuums for both cognitive and mental health challenges. Read More

    Integration of Pediatric Behavioral Health Services in Primary Care: Improving Access and Outcomes with Collaborative Care.
    Can J Psychiatry 2018 Jan 1:706743717751668. Epub 2018 Jan 1.
    3 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
    Objective: To examine collaborative care interventions to integrate pediatric mental health services into primary care as a means of addressing barriers to mental health service delivery, improving access to care, and improving health outcomes.

    Method: Selective review of published literature addressing structural and attitudinal barriers to behavioural health service delivery and the integration of behavioural health services for pediatric mental problems and disorders into primary care settings, with a special focus on Canadian and U.S. Read More

    Use of Placebo in Clinical Trials of Psychotropic Medication.
    Can J Psychiatry 2018 May;63(5):338-341
    5 Professor and BC Leadership Chair in Depression Research, Department of Psychiatry, University of British Columbia; Director, Mood Disorders Centre, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia.
    This position paper has been substantially revised by the Canadian Psychiatric Association's Research Committee and approved for republication by the CPA's Board of Directors on March 31, 2017. The original position paper was developed by the Scientific and Research Council and approved by the Board of Directors on October 4, 1996. Read More

    Social Determinants of Health and Preclinical Glycemic Control in Newly Diagnosed First-Episode Psychosis Patients.
    Can J Psychiatry 2018 Jan 1:706743718762097. Epub 2018 Jan 1.
    1 Prevention and Early Intervention Program for Psychosis, Montreal, Quebec.
    Background: The abnormally high incidence of disorders of glucose metabolism (DGM) in psychotic-spectrum disorders (PSD) has often been attributed to the side effects of antipsychotics and unhealthy lifestyles. The influence of social determinants of health has been largely ignored, despite ample evidence linking social adversity with both PSD and DGM. The aim of this study is to examine the influence of well-established social determinants of health on preclinical levels of glycated hemoglobin (HbA1c) in a sample of first-episode psychosis (FEP) patients. Read More

    International Medical Graduates in Psychiatry: Cultural Issues in Training and Continuing Professional Development.
    Can J Psychiatry 2018 Apr;63(4):258-280
    8 Clinical Professor, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia; Director, Crosscultural Program, University of British Columbia, Vancouver, British Columbia.
    A position paper developed by the Canadian Psychiatric Association's Education Committee and approved by the CPA's Board of Directors on August 15, 2016. Read More

    Coercion in Outpatients under Community Treatment Orders: A Matched Comparison Study.
    Can J Psychiatry 2018 Jan 1:706743718766053. Epub 2018 Jan 1.
    8 Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
    Objective: Since the deinstitutionalization of psychiatric services around the world, the scope of outpatient psychiatric care has also increased to better support treatment access and adherence. For those with serious mental illness who may lack insight into their own illness, available interventions include coercive community practices such as mandated community treatment orders (CTOs). This paper examines the perceptions of coercion among service users treated with a CTO. Read More

    Thirty-Day and 5-Year Readmissions following First Psychiatric Hospitalization: A System-Level Study of Ontario's Psychiatric Care.
    Can J Psychiatry 2018 Jun 28;63(6):410-415. Epub 2018 Mar 28.
    2 University of Toronto Department of Psychiatry, Toronto, Ontario, Canada.
    Objective: Analyses of representative, system-level data to examine trends in short- and longer-term readmission rates for psychiatric illnesses are largely absent. The objective of this article is to examine key trends and variables with implications for inpatient care as indicated by 30-day readmission and outpatient care as reflected by readmission within 5 years.

    Methods: Using OMHRS data from 2005 to 2015, patients who had their first inpatient admission were followed for 5 years to examine their subsequent 30-day and overall admission rates stratified by discharge time and diagnosis. Read More

    Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization.
    Can J Psychiatry 2018 Jan 1:706743717752881. Epub 2018 Jan 1.
    1 Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario.
    Objective: The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area.

    Method: The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. Read More

    Disparities in Access to Early Psychosis Intervention Services: Comparison of Service Users and Nonusers in Health Administrative Data.
    Can J Psychiatry 2018 Jun 21;63(6):395-403. Epub 2018 Mar 21.
    3 Institute for Clinical Evaluative Sciences, Toronto, Ontario.
    Objective: There is a dearth of information on people with first-episode psychosis who do not access specialized early psychosis intervention (EPI) services. We sought to estimate the proportion of incident cases of nonaffective psychosis that do not access these services and to examine factors associated with EPI admission.

    Methods: Using health administrative data, we constructed a retrospective cohort of incident cases of nonaffective psychosis in the catchment area of the Prevention and Early Intervention Program for Psychoses (PEPP) in London, Ontario, between 1997 and 2013. Read More

    Patient, Treatment, and Health Care Utilization Variables Associated with Adherence to Metabolic Monitoring Practices in Children and Adolescents Taking Second-Generation Antipsychotics.
    Can J Psychiatry 2018 Apr 11;63(4):240-249. Epub 2018 Mar 11.
    1 Department of Health Sciences, School of Nursing, Queen's University, Kingston, Ontario.
    Objective: Children and adolescents with a range of psychiatric disorders are increasingly being prescribed atypical or second-generation antipsychotics (SGAs). While SGAs are effective at treating conduct and behavioural symptoms, they infer significant cardiometabolic risk. This study aims to explore what patient, treatment, and health care utilization variables are associated with adherence to Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) metabolic monitoring guidelines. Read More

    Youth Mental Health Should Be a Top Priority for Health Care in Canada.
    Can J Psychiatry 2018 Apr 11;63(4):216-222. Epub 2018 Mar 11.
    10 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
    In this article we have provided a perspective on the importance and value of youth mental health services for society and argued that advancing youth mental health services should be the number one priority of health services in Canada. Using the age period of 12-25 years for defining youth, we have provided justification for our position based on scientific evidence derived from clinical, epidemiological and neurodevelopmental studies. We have highlighted the early onset of most mental disorders and substance abuse as well as their persistence into later adulthood, the long delays experienced by most help seekers and the consequence of such delays for young people and for society in general. Read More

    Ethnic Differences in Mental Health Status and Service Utilization: A Population-Based Study in Ontario, Canada.
    Can J Psychiatry 2018 Jan 1:706743717741061. Epub 2018 Jan 1.
    1 Mental Health and Addictions Program, Institute for Clinical Evaluative Sciences, Toronto, Ontario.
    Background: The purpose of this study was to compare the prevalence of self-reported mental health factors, mental health service use, and unmet needs across the 4 largest ethnic groups in Ontario, Canada: white, South Asian, Chinese, and black groups.

    Methods: The study population was derived from the Canadian Community Health Survey, using a cross-sectional sample of 254,951 white, South Asian, Chinese, and black residents living in Ontario, Canada, between 2001 and 2014. Age- and sex-standardized prevalence estimates for mental health factors, mental health service use, and unmet needs were calculated for each of the 4 ethnic groups overall and by sociodemographic characteristics. Read More

    Neighbourhood Material and Social Deprivation and Exposure to Antidepressant Drug Treatment: A Cohort Study Using Administrative Data.
    Can J Psychiatry 2018 Jan 1:706743718760290. Epub 2018 Jan 1.
    1 Faculty of Pharmacy, Université Laval Québec, Québec.
    Objective: To assess whether neighbourhood deprivation is associated with exposure to an antidepressant drug treatment (ADT) and its quality among individuals diagnosed with unipolar depression and insured by the Quebec public drug plan.

    Method: We conducted an administrative database cohort study of adults covered by the Quebec public drug plan who were diagnosed with a new episode of unipolar depression. We assessed material and social deprivation using an area-based index. Read More

    Quality Review in Psychiatry.
    Can J Psychiatry 2018 Mar;63(3):197-211
    3 Associate Professor, Departments of Psychiatry and Medicine, Western University; Scholarly Portfolio Lead, Residency Program Committee, Department of Psychiatry, Western University; Physician Lead, General Adult Ambulatory Mental Health Service, London Health Sciences Centre (Victoria Hospital), London, Ontario.
    This position paper has been substantially revised by the Canadian Psychiatric Association's Professional Standards and Practice Committee and approved for republication by the CPA's Board of Directors on August 31, 2016. The original position paper was developed by the Professional Standards and Practice Council and approved by the Board of Directors on April 9, 1994. Read More

    Integrated Care for Depression in Older Primary Care Patients.
    Can J Psychiatry 2018 Jan 1:706743718760292. Epub 2018 Jan 1.
    2 Weill Cornell Medical College, New York, NY, USA.
    For decades, depression in older adults was overlooked and not treated. Most treatment was by primary care providers and typically poorly managed. Recent interventions that integrate mental health services into primary care have increased the number of patients who are treated for depression and the quality of that treatment. Read More


    Mental Health Screening and Differences in Access to Care among Prisoners.
    Can J Psychiatry 2018 Jan 1:706743718762099. Epub 2018 Jan 1.
    2 School of Epidemiology and Public Health, University of Ottawa, Ontario.
    Objective: Disparities in mental health care exist between regional and demographic groups. While screening is recommended as part of a correctional mental health strategy, little work has been done to explore whether it can narrow regional and demographic disparities in access to care. We compared treatment access rates by sex, race, age, and region in relation to screening results. Read More

    Mental Disorder, Psychological Distress, and Functional Status in Canadian Military Personnel.
    Can J Psychiatry 2018 Jan 1:706743718762098. Epub 2018 Jan 1.
    1 School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario.
    Objective: We examined the overlap between mood and anxiety disorders and psychological distress and their associations with functional status in Canadian Armed Forces (CAF) personnel.

    Method: Data on Regular Forces personnel ( N = 6700) were derived from the 2013 Canadian Forces Mental Health Survey, a nationally representative survey of the CAF personnel. Current psychological distress was assessed using the Kessler K10 scale. Read More

    Workplace Mental Health Training in Health Care: Key Ingredients of Implementation.
    Can J Psychiatry 2018 Jan 1:706743718762100. Epub 2018 Jan 1.
    7 Physical Therapy and Surgery, Western University, London, Ontario, Canada.
    Objectives: Despite growing awareness of the importance of workplace mental health training and an increasing number of educational resources, there is a gap in knowledge regarding what shapes training effectiveness. The purpose of this study was to compare and describe the active ingredients of 2 workplace mental health education programs for health care workers.

    Methods: Within the context of a randomized clinical trial, a multimethod process evaluation was conducted to explore key process elements shaping implementation outcomes: the innovation, service recipients, service providers, and the organizational context. Read More

    Do Investments in Mental Health Systems Result in Greater Use of Mental Health Services? National Trends in Mental Health Service Use (MHSU) in the Canadian Military and Comparable Canadian Civilians, 2002-2013.
    Can J Psychiatry 2018 Jan 1:706743718760291. Epub 2018 Jan 1.
    3 Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, Ontario.
    Background: Mental disorders constitute a significant public health problem worldwide. Ensuring that those who need mental health services access them in an appropriate and timely manner is thus an important public health priority. We used data from 4 cross-sectional, nationally representative population health surveys that employed nearly identical methods to compare MHSU trends in the Canadian military versus comparable civilians. Read More

    Geographic Clustering of Admissions to Inpatient Psychiatry among Adults with Cognitive Disorders in Ontario, Canada: Does Distance to Hospital Matter?
    Can J Psychiatry 2018 Jun 6;63(6):404-409. Epub 2018 Feb 6.
    1 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
    Objective: This study examined relationships among hospital accessibility, socio-economic context, and geographic clustering of inpatient psychiatry admissions for adults with cognitive disorders in Ontario, Canada.

    Method: A retrospective cross-sectional analysis was conducted using admissions data from 71 hospitals with inpatient psychiatry beds in Ontario, Canada between 2011 and 2014. Data included 7,637 unique admissions for 4,550 adults with a DSM-IV diagnosis of Delirium, Dementia, Amnestic and other Cognitive Disorders. Read More

    Acute Care Use for Ambulatory Care-Sensitive Conditions in High-Cost Users of Medical Care with Mental Illness and Addictions.
    Can J Psychiatry 2018 Jan 1:706743717752880. Epub 2018 Jan 1.
    1 Department of Psychiatry, Women's College Hospital and University of Toronto, Toronto, Ontario.
    Objective: The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care-sensitive conditions (ACSCs) among high-cost users of medical care.

    Method: A retrospective, population-based cohort study using data from Ontario, Canada. Read More

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