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Journal Cover Canadian Journal of Psychiatry
  [SJR: 1.631]   [H-I: 87]   [17 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0706-7437 - ISSN (Online) 1497-0015
   Published by Sage Publications Homepage  [853 journals]
  • Screening for Depression in Children and Youth: It Seems That We Just Dont
    • Authors: Thompson; A. H.
      Pages: 744 - 745
      PubDate: 2016-11-10T14:59:31-08:00
      DOI: 10.1177/0706743716672399
      Issue No: Vol. 61, No. 12 (2016)
  • Accuracy of Depression Screening Tools to Detect Major Depression in
           Children and Adolescents: A Systematic Review
    • Authors: Roseman, M; Kloda, L. A, Saadat, N, Riehm, K. E, Ickowicz, A, Baltzer, F, Katz, L. Y, Patten, S. B, Rousseau, C, Thombs, B. D.
      Pages: 746 - 757
      Abstract: Objective:Depression screening among children and adolescents is controversial, and no clinical trials have evaluated benefits and harms of screening programs. A requirement for effective screening is a screening tool with demonstrated high accuracy. The objective of this systematic review was to evaluate the accuracy of depression screening instruments to detect major depressive disorder (MDD) in children and adolescents.Method:Data sources included the MEDLINE, MEDLINE In-Process, EMBASE, PsycINFO, HaPI, and LILACS databases from 2006 to September 30, 2015. Eligible studies compared a depression screening tool to a validated diagnostic interview for MDD and reported accuracy data for children and adolescents aged 6 to 18 years. Risk of bias was assessed with QUADAS-2.Results:We identified 17 studies with data on 20 depression screening tools. Few studies examined the accuracy of the same screening tools. Cut-off scores identified as optimal were inconsistent across studies. Width of 95% confidence intervals (CIs) for sensitivity ranged from 9% to 55% (median 32%), and only 1 study had a lower bound 95% CI ≥80%. For specificity, 95% CI width ranged from 2% to 27% (median 9%), and 3 studies had a lower bound ≥90%. Methodological limitations included small sample sizes, exploratory data analyses to identify optimal cut-offs, and the failure to exclude children and adolescents already diagnosed or treated for depression.Conclusions:There is insufficient evidence that any depression screening tool and cut-off accurately screens for MDD in children and adolescents. Screening could lead to overdiagnosis and the consumption of scarce health care resources.
      PubDate: 2016-11-10T14:59:31-08:00
      DOI: 10.1177/0706743716651833
      Issue No: Vol. 61, No. 12 (2016)
  • Interprovincial Variation in Antipsychotic and Antidepressant
           Prescriptions Dispensed in the Canadian Pediatric Population
    • Authors: Arora, N; Knowles, S, Gomes, T, Mamdani, M. M, Juurlink, D. N, Carlisle, C, Tadrous, M.
      Pages: 758 - 765
      Abstract: Objective:Although antidepressants and antipsychotics are valuable medications in the treatment of select psychiatric disorders, there is increasing focus on the balance of risks and benefits of these drugs as prescribed, particularly in the pediatric population. We examined recent national trends and interprovincial variation in dispensing of antipsychotic and antidepressant prescriptions to the Canadian pediatric population.Method:We conducted a population-based cross-sectional study of antidepressant and antipsychotic prescriptions dispensed by Canadian pharmacies to the pediatric population (≤18 years) between 2010 and 2013. Prescription volumes were obtained from IMS Health. Analysis was stratified by drug, year, quarter, and province and population-standardized using age-adjusted population estimates.Results:From the first quarter of 2010 to the fourth quarter of 2013, dispensing of antipsychotics to the pediatric population increased 33% (from 34 to 45 prescriptions per 1000) and dispensing of antidepressants increased 63% (from 34 to 55 per 1000). We observed a 1.5-fold interprovincial difference in dispensing rates for antidepressants (range: 189 per 1000 to 275 per 1000) and a 3.0-fold difference for antipsychotics (range: 85 per 1000 to 253 per 1000) in 2013. Among antidepressants, selective serotonin reuptake inhibitors were the most dispensed (76%), with fluoxetine being the leading agent. Among antipsychotics, atypical antipsychotics were the most dispensed (97%), with risperidone being the leading agent.Conclusions:Antipsychotic and antidepressant dispensing to the Canadian pediatric population increased from 2010 to 2013, with considerable interprovincial variation. Future research is required to explore reasons for observed patterns to optimize care for the Canadian pediatric population.
      PubDate: 2016-11-10T14:59:31-08:00
      DOI: 10.1177/0706743716649190
      Issue No: Vol. 61, No. 12 (2016)
  • Mental Health Services for Students at Postsecondary Institutions: A
           National Survey
    • Authors: Jaworska, N; De Somma, E, Fonseka, B, Heck, E, MacQueen, G. M.
      Pages: 766 - 775
      Abstract: Objective:Although the high prevalence of mental health issues among postsecondary students is well documented, comparatively little is known about the adequacy, accessibility, and adherence to best practices of mental health services (MHSs)/initiatives on postsecondary campuses. We evaluated existing mental health promotion, identification, and intervention initiatives at postsecondary institutions across Canada, expanding on our previous work in one Canadian province.Methods:A 54-question online survey was sent to potential respondents (mainly front-line workers dealing directly with students [e.g., psychologists/counsellors, medical professionals]) at Canada’s publicly funded postsecondary institutions. Data were analyzed overall and according to institutional size (small [10 000 students]).Results:In total, 168 out of 180 institutions were represented, and the response rate was high (96%; 274 respondents). Most institutions have some form of mental health promotion and outreach programs, although most respondents felt that these were not a good use of resources. Various social supports exist at most institutions, with large ones offering the greatest variety. Most institutions do not require incoming students to disclose mental health issues. While counselling services are typically available, staff do not reliably have a diverse complement (e.g., gender or race diversity). Counselling sessions are generally limited, and follow-up procedures are uncommon. Complete diagnostic assessments and the use of standardized diagnostic systems are rare.Conclusions:While integral MHSs are offered at most Canadian postsecondary institutions, the range and depth of available services are variable. These data can guide policy makers and stakeholders in developing comprehensive campus mental health strategies.
      PubDate: 2016-11-10T14:59:32-08:00
      DOI: 10.1177/0706743716640752
      Issue No: Vol. 61, No. 12 (2016)
  • Individual- and Relationship-Level Factors Related to Better Mental Health
           Outcomes following Child Abuse: Results from a Nationally Representative
           Canadian Sample
    • Authors: Afifi, T. O; MacMillan, H. L, Taillieu, T, Turner, S, Cheung, K, Sareen, J, Boyle, M. H.
      Pages: 776 - 788
      Abstract: Objective:Child abuse can have devastating mental health consequences. Fortunately, not all individuals exposed to child abuse will suffer from poor mental health. Understanding what factors are related to good mental health following child abuse can provide evidence to inform prevention of impairment. Our objectives were to 1) describe the prevalence of good, moderate, and poor mental health among respondents with and without a child abuse history; 2) examine the relationships between child abuse and good, moderate, and poor mental health outcomes; 3) examine the relationships between individual- and relationship-level factors and better mental health outcomes; and 4) determine if individual- and relationship-level factors moderate the relationship between child abuse and mental health.Method:Data were from the nationally representative 2012 Canadian Community Health Survey: Mental Health (n = 23,395; household response rate = 79.8%; 18 years and older). Good, moderate, and poor mental health was assessed using current functioning and well-being, past-year mental disorders, and past-year suicidal ideation.Results:Only 56.3% of respondents with a child abuse history report good mental health compared to 72.4% of those without a child abuse history. Individual- and relationship-level factors associated with better mental health included higher education and income, physical activity, good coping skills to handle problems and daily demands, and supportive relationships that foster attachment, guidance, reliable alliance, social integration, and reassurance of worth.Conclusions:This study identifies several individual- and relationship-level factors that could be targeted for intervention strategies aimed at improving mental health outcomes following child abuse.
      PubDate: 2016-11-10T14:59:32-08:00
      DOI: 10.1177/0706743716651832
      Issue No: Vol. 61, No. 12 (2016)
  • Factors Associated with Suicidal Thought and Help-Seeking Behaviour in
           Transition-Aged Youth versus Adults
    • Authors: MacKinnon, N; Colman, I.
      Pages: 789 - 796
      Abstract: Objective:Suicide is a leading cause of death for transition-aged youth (TAY), and yet few studies examine correlates of suicidal ideation specifically in this age demographic (age 18-24 years). The transition to adulthood is a unique context, marked by novel stressors (e.g., joining the workforce) and increased independence, which may influence risk factors for suicidal ideation. This study examined correlates of suicidal ideation in TAY and adults and contrasted profiles across age.Methods:We used 4 biannual cycles (2005, 2007, 2009, 2011) of the Canadian Community Health Survey, a population-based cross-sectional survey on health. We used logistic regression to assess the association between suicidal ideation and depression, distress, alcohol use, smoking, exercise, sedentary behaviour, chronic illness, restrictions to daily living, perceived physical and mental health, and perceived social support independently in both TAY (n = 4427) and adults (n = 14,452). We subsequently assessed possible interactions with age (18-24 v. 25-44 years) and sex and differences in help-seeking behaviour in a combined model.Result:TAY exhibited higher rates of suicidal ideation than adults did (P < 0.001). Numerous factors were associated with suicidal ideation in TAY. Notably, alcohol abstinence was associated with decreased suicidal ideation in TAY but not for adults. Moreover, when depressed, TAY were significantly less likely to have received professional mental health help than adults (odds ratio = 0.64, 95% CI, 0.43 to 0.94).Conclusions:Suicidal ideation is more prevalent in TAY than adults, and its consequences may be aggravated by poor treatment-seeking behaviour in at-risk (i.e. depressed) individuals. These different risk profiles substantiate the recent shift toward clinical interventions focusing on transition-aged youth, rather than traditional child (18 years) services.
      PubDate: 2016-11-10T14:59:32-08:00
      DOI: 10.1177/0706743716667417
      Issue No: Vol. 61, No. 12 (2016)
  • Trends in Psychological Symptoms among Canadian Adolescents from 2002 to
           2014: Gender and Socioeconomic Differences
    • Authors: Gariepy, G; Elgar, F. J.
      Pages: 797 - 802
      Abstract: Objective:To describe trends in psychological health symptoms in Canadian youth from 2002 to 2014 and examine gender and socioeconomic differences in these trends.Method:We used data from the Canadian Health Behaviour in School-aged Children (HBSC) study. We assessed psychological symptoms from a validated symptom checklist and calculated a symptom score (range, 0-16). We stratified our analyses by gender and affluence tertile based on an index of material assets. We then plotted trends in symptom score and calculated the probability of experiencing specific symptoms over time.Results:Between 2002 and 2014, psychological symptom score increased by 1.01 (95% confidence interval [CI], 0.73 to 1.41), 1.08 (95% CI, 0.79 to 1.37), and 0.84 (95% CI, 0.55 to 1.13) points in girls in the low-, middle-, and high-affluence tertiles, respectively. In boys, psychological symptoms decreased by –0.39 (95% CI, –0.66 to –0.12) and –0.12 (95% CI, –0.43 to 0.19) points in the high- and middle-affluence tertiles, respectively, and increased by 0.30 (95% CI, –0.04 to 0.63) points in the low-affluence tertile. The probability of feeling anxious and having sleep problems at least once a week notably increased in girls from all affluence groups, while the probability of feeling depressed and irritable decreased among boys from the high-affluence tertile.Conclusion:Psychological symptoms increased in Canadian adolescent girls across all affluence groups while they remained stable in boys from low and middle affluence and decreased in boys from high affluence. Specific psychological symptoms followed distinct trends. Further research is needed to uncover the mechanisms driving these trends.
      PubDate: 2016-11-10T14:59:32-08:00
      DOI: 10.1177/0706743716670130
      Issue No: Vol. 61, No. 12 (2016)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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