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Journal Cover Canadian Journal of Psychiatry
  [SJR: 1.244]   [H-I: 79]   [16 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  [839 journals]
  • Marijuana Use in Youth from Bench to Bedside to Longitudinal Outlook
    • Authors: Osuch; E.
      Pages: 316 - 317
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716644148
      Issue No: Vol. 61, No. 6 (2016)
  • Cannabis Use in Adolescence and Young Adulthood: A Review of Findings from
           the Victorian Adolescent Health Cohort Study
    • Authors: Coffey, C; Patton, G. C.
      Pages: 318 - 327
      Abstract: The Victorian Adolescent Health Cohort Study (VAHCS) is a long-term Australian cohort study that has documented cannabis use in young Australians from the mid-teens to the mid-30s. The study findings have described the natural history of early cannabis use, remission, and escalation and the social and mental health consequences of different patterns of use. The adverse consequences of cannabis use are most clear-cut in heavy early adolescent users. These consequences include educational failure, persisting mental health problems, and progression to other substance use. For later onset and occasional users, the risks are lower and appear to entail modest elevations in risk for other drug use compared with never users. With growing evidence of health consequences, there is a strong case for actions around early heavy adolescent users. Prevention of early use, identification and treatment of early heavy users, and harm reduction through diversion of early heavy users away from the custodial justice system into health care are all priority responses.
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716645289
      Issue No: Vol. 61, No. 6 (2016)
  • What Can Rats Tell Us about Adolescent Cannabis Exposure' Insights
           from Preclinical Research
    • Authors: Renard, J; Rushlow, W. J, Laviolette, S. R.
      Pages: 328 - 334
      Abstract: Marijuana is the most widely used drug of abuse among adolescents. Adolescence is a vulnerable period for brain development, during which time various neurotransmitter systems such as the glutamatergic, GABAergic, dopaminergic, and endocannabinoid systems undergo extensive reorganization to support the maturation of the central nervous system (CNS). -9-tetrahydrocannabinol (THC), the psychoactive component of marijuana, acts as a partial agonist of CB1 cannabinoid receptors (CB1Rs). CB1Rs are abundant in the CNS and are central components of the neurodevelopmental changes that occur during adolescence. Thus, overactivation of CB1Rs by cannabinoid exposure during adolescence has the ability to dramatically alter brain maturation, leading to persistent and enduring changes in adult cerebral function. Increasing preclinical evidence lends support to clinical evidence suggesting that chronic adolescent marijuana exposure may be associated with a higher risk for neuropsychiatric diseases, including schizophrenia. In this review, we present a broad overview of current neurobiological evidence regarding the long-term consequences of adolescent cannabinoid exposure on adult neuropsychiatric-like disorders.
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716645288
      Issue No: Vol. 61, No. 6 (2016)
  • The "Vulnerability" of Psychiatric Research Participants: Why This
           Research Ethics Concept Needs to Be Revisited
    • Authors: Bracken-Roche, D; Bell, E, Racine, E.
      Pages: 335 - 339
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716633422
      Issue No: Vol. 61, No. 6 (2016)
  • Ethno-Racial Variation in Recovery From Severe Mental Illness: A
           Qualitative Comparison
    • Authors: Whitley; R.
      Pages: 340 - 347
      Abstract: Objective: Purpose-driven studies examining the relationship between ethnicity, culture, and recovery are absent from the empirical literature. As such, the overall aim of this study was to examine ethno-racial variations in recovery perspectives. Specific objectives consist of comparing and contrasting ethno-racial variations in 1) definitions of recovery, 2) barriers to recovery, and 3) facilitators of recovery. Methods: We recruited people with severe mental illness from 2 broad ethno-racial groups (Caribbean-Canadian and Euro-Canadian) to partake in a qualitative interview on recovery (n = 47). Participants were asked to give their own definitions of recovery, as well as self-perceived barriers and facilitators. Interview transcripts were then subjected to thematic analysis. We compared and contrasted the distribution and salience of emerging themes between the Euro-Canadian and Caribbean-Canadian participants. Results: Recovery was consistently defined as a gradual process involving progress in key life domains including employment, social engagement, and community participation by both groups. This was underpinned by a growing future orientation. Stigma, financial strain, and psychiatric hospitalization were considered major barriers to recovery in both groups. Participants from both groups generally considered stated definitions of recovery to be simultaneous facilitators of recovery—employment and social engagement being the most frequently mentioned. God and religion were key facilitators for the Caribbean-Canadian group but not for Euro-Canadians. Conclusions: Definitions, barriers, and facilitators to recovery were generally shared among our sample, regardless of ethno-racial status, with the exception of God and religion.
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716643740
      Issue No: Vol. 61, No. 6 (2016)
  • Military Occupational Outcomes in Canadian Armed Forces Personnel with and
           without Deployment-Related Mental Disorders
    • Authors: Boulos, D; Zamorski, M. A.
      Pages: 348 - 357
      Abstract: Objective: Mental disorders are common in military organizations, and these frequently lead to functional impairments that can interfere with duties and lead to costly attrition. In Canada, the military mental health system has received heavy investment to improve occupational outcomes. We investigated military occupational outcomes of diagnosed mental disorders in a cohort of 30,513 personnel who deployed on the Afghanistan mission. Methods: Cohort members were military personnel who deployed on the Afghanistan mission from 2001 to 2008. Mental disorder diagnoses and their attribution to the Afghanistan mission were ascertained via medical records in a stratified random sample (n = 2014). Career-limiting medical conditions (that is, condition-associated restrictions that reliably lead to medically related attrition) were determined using administrative data. Outcomes were assessed from first Afghanistan-related deployment return. Results: At 5 years of follow-up, the Kaplan-Meier estimated cumulative fraction with career-limiting medical conditions was 40.9% (95% confidence interval [CI] 35.5 to 46.4) among individuals with Afghanistan service–related mental disorders (ARMD), 23.6% (CI 15.5 to 31.8) with other mental disorders, and 11.1% (CI 8.9 to 13.3) without mental disorders. The adjusted Cox regression hazard ratios for career-limiting medical condition risk were 4.89 (CI 3.85 to 6.23) among individuals with ARMD and 2.31 (CI 1.48 to 3.60) with other mental disorders, relative to those without mental disorders. Conclusions: Notwithstanding the Canadian military’s mental health system investments, mental disorders (particularly ARMD) still led to a high risk of adverse military occupational outcomes. Such investments have intrinsic value but may not translate into reduced medically related attrition without improvements in prevention and treatment effectiveness.
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716643742
      Issue No: Vol. 61, No. 6 (2016)
  • Rates of Mental Illness and Addiction among High-Cost Users of Medical
           Services in Ontario
    • Authors: Hensel, J. M; Taylor, V. H, Fung, K, Vigod, S. N.
      Pages: 358 - 366
      Abstract: Objective: To quantify the burden of mental illness and addiction among high-costing users of medical services (HCUs) using population-level data from Ontario, and compare to a referent group of nonusers. Method: We conducted a population-level cohort study using health administrative data from fiscal year 2011-2012 for all Ontarians with valid health insurance as of April 1, 2011 (N = 10,909,351). Individuals were grouped based on medical costs for hospital, emergency, home, complex continuing, and rehabilitation care in 2011-2012: top 1%, top 2% to 5%, top 6% to 50%, bottom 50%, and a zero-cost nonuser group. The rate of diagnosed psychotic, major mood, and substance use disorders in each group was compared to the zero-cost referent group with adjusted odds ratios (AORs) for age, sex, and socioeconomic status. A sensitivity analysis included anxiety and other disorders. Results: Mental illness and addiction rates increased across cost groups affecting 17.0% of the top 1% of users versus 5.7% of the zero-cost group (AOR, 3.70; 95% confidence interval [CI], 3.59 to 3.81). This finding was most pronounced for psychotic disorders (3.7% vs. 0.7%; AOR, 5.07; 95% CI, 4.77 to 5.38) and persisted for mood disorders (10.0% vs. 3.3%; AOR, 3.52; 95% CI, 3.39 to 3.66) and substance use disorders (7.0% vs. 2.3%; AOR, 3.82; 95% CI, 3.66 to 3.99). When anxiety and other disorders were included, the rate of mental illness was 39.3% in the top 1% compared to 21.3% (AOR, 2.39; 95% CI, 2.34 to 2.45). Conclusions: A high burden of mental illness and addiction among HCUs warrants its consideration in the design and delivery of services targeting HCUs.
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716644764
      Issue No: Vol. 61, No. 6 (2016)
  • Psychosocial Interventions in Reducing Cannabis Use in Early Phase
           Psychosis: A Canadian Survey of Treatments Offered
    • Authors: Aydin, C; Tibbo, P. G, Ursuliak, Z.
      Pages: 367 - 372
      Abstract: Objective: Cannabis use in people with early phase psychosis (EPP) can have a significant impact on long-term outcomes. The purpose of this investigation was to describe current cannabis use treatment practices in English-speaking early intervention services (EISs) in Canada and determine if their services are informed by available evidence. Method: Thirty-five Canadian English-speaking EISs for psychosis were approached to complete a survey through email, facsimile, or online in order to collect information regarding their current cannabis use treatment practices. Results: Data were acquired from 27 of the 35 (78%) programs approached. Only 12% of EISs offered formal services that targeted cannabis use, whereas the majority (63%) of EISs offered informal services for all substance use, not specifically cannabis. In programs with informal services, individual patient psychoeducation (86%) was slightly more common than individual motivational interviewing (MI) (76%) followed by group patient psychoeducation (52%) and information handouts (52%). Thirty-seven percent of EISs offered formal services for substance use, and compared to programs with informal services, more MI, cognitive-behavioural therapy, and family services were offered, with individual treatment modalities more common than groups. No EISs used contingency management, even though it has some preliminary evidence in chronic populations. Evidence-based service implementation barriers included appropriate training and administrative support. Conclusions: While most English-speaking Canadian EIS programs offer individual MI and psychoeducation, which is in line with the available literature, there is room for improvement in cannabis treatment services based on current evidence for both people with EPP and their families.
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716639931
      Issue No: Vol. 61, No. 6 (2016)
  • Book Review: Overdiagnosis in Psychiatry: How Modern Psychiatry Lost Its
           Way While Creating a Diagnosis for Almost All of Lifes Misfortunes
    • Authors: Klein; J.
      Pages: 373 - 374
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716645303
      Issue No: Vol. 61, No. 6 (2016)
  • Book Review: The Intelligent Clinicians Guide to the DSM-5
    • Authors: Patten; S. B.
      Pages: 374 - 374
      PubDate: 2016-05-09T16:59:07-07:00
      DOI: 10.1177/0706743716642417
      Issue No: Vol. 61, No. 6 (2016)
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