Psychiatry and Psychology Commons^™

A Rapid Review Of The Barriers And Facilitators Of Mental Health Service Access Among Veterans And Their Families, Natalie Ein, Julia Gervasio, Kate St. Cyr, Jenny J.W. Liu, Clara Baker, Anthony Nazarov, J. Don Richardson

MacDonald Franklin OSI Research Centre

Introduction: Transitioning to civilian life after military service can be challenging for both Veterans and their families. Accessible mental health services are crucial during this period to provide support. The objective of this review was to conduct a rapid review to capture the barriers and identify facilitators that influence access to mental health services for Veterans and their families during the post-service transition period.

Methods: This review was conducted using the Cochrane Handbook for Systematic Reviews of Interventions as a methodological framework and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Rapid Review (PRISMA-RR).

Results: A total …

Prenatal Maternal Depression In Canada: Are Current Protocols Adequate?, Britney A. Glasgow-Osment, Farah Wahib, Madeleine Zanin, Shama Kassam

Master's in Interdisciplinary Medical Sciences Graduate Program

Throughout pregnancy, maternal and fetal health are influenced by a multitude of factors. Prenatal maternal depression is one such factor. It is well documented that prenatal maternal depression causes negative pregnancy outcomes for both the mother and baby, including irregular placental function, psychological distress, and pre-term birth, among others. In Ontario, the incidence of prenatal maternal depression is alarmingly high, at 10.3%.As such, the current tools for managing prenatal maternal depression must be effective, efficient, and comprehensive. We hypothesized that the current protocols for screening and treating prenatal maternal depression in Canada are inadequate. To investigate this, a literature review …

Bridging The Transition To Housing: A Social Justice Framework To Guide The Practice Of Occupational Therapists And Other Professionals Who Support Individuals With Experiences Of Homelessness (2nd Ed), Carrie Marshall, Rebecca Gewurtz, Skye Barbic, Laurence Roy, Abrial Cooke, Rosemary Lysaght

Occupational Therapy Publications

Occupational therapists have been supporting individuals who experience homelessness for several decades in their roles as community mental health therapists, on in-patient units, in traumatic brain injury programs, and in multiple other roles. Only recently, however, has this area of practice been acknowledged as distinct. Homelessness is growing in several high and middle-income countries worldwide. Occupational therapists have increasingly expressed an interest in gaining the knowledge and skills to effectively support individuals who experience homelessness, and in recent years, research in occupational therapy that focuses specifically on persons who experience homelessness has grown. The majority of individuals who have been …

The Influence Of Depression-Ptsd Comorbidity On Health-Related Quality Of Life In Treatment-Seeking Veterans, Callista Forchuk, Anthony Nazarov, Renee Hunt, Brent Davis, Kate St. Cyr, J Donald Richardson

Psychiatry Publications

Objective: Posttraumatic stress disorder (PTSD) and depression substantially impair healthrelated quality of life (HRQOL) for many Canadian Armed Forces (CAF) veterans. Although PTSD and depression are highly comorbid, little is known about whether the disorders may interact in their association with HRQOL. We sought to investigate whether depressive symptoms modify the relation between PTSD and HRQOL in treatment-seeking veterans. Method: We accessed the clinical data of 545 CAF veterans aged 18 to 65 years who were seeking treatment at a specialized clinic in London, Ontario. We used hierarchical linear regression to assess the additive and multiplicative relations between depression and …

Dance As A Protective Measure Against The Cognitive And Physical Declines Associated With Aging: A Proposed Study, Sarah M. Schwanz, Jeffrey Holmes, Jessica Grahn

Western Research Forum

Background:

Dance is considered a multimodal activity in that it requires both physical and cognitive engagement. Combining physical activity with music may have a synergistic effect, enabling dance to enhance physical and cognitive functions more than music and physical activity alone. The positive changes attributed to dance training such as improved visuospatial and motor ability, high coordination, greater balance, and increased cognitive ability may also benefit individuals as they age.

Methods:

This proposed study will examine whether dance training has the potential to protect against age-related cognitive and physical decline by assessing the cognitive and physical domains that show decline …

Mouse Performance On A Novel Touchscreen Continuous Performance Task Is Dependent On Signaling In The Prelimbic Cortex, Tyler D. Dexter, Daniel Palmer, Amy C. Reichelt, Anita Taksokhan, Lisa M. Saksida, Tim J. Bussey

Western Research Forum

Attention is the cognitive processing that facilitates the ability to target and attend to relevant environmental stimuli, while filtering out irrelevant or distracting stimuli. Control over selective attention is theorized to be dependent on organized neural communication that stems from the medial prefrontal cortex (mPFC). To evaluate selective and sustained attention, mice were trained on the novel touchscreen rodent continuous performance task (rCPT), a task designed to emulate the human CPT. In the rodent version, images are continuously presented on a touchscreen, where mice have been trained to selectively respond to one image type while suppressing responses to all others. …

Pparg Signaling In The Nucleus Accumbens Regulates Mesolimbic Dopamine Activity, Tony Jung, Roger Hudson, Hanna Szkudlarek, Walter Rushlow, Steve Laviolette

Western Research Forum

Background: The mesolimbic dopamine system consists of dopamine neuron projections from the ventral tegmental area (VTA) to the nucleus accumbens (NAc). The NAc regulates VTA dopamine release through inhibitory GABA projections to the VTA. Hyperactive mesolimbic dopamine signaling is implicated in anxiety. Cannabidiol, a compound found in cannabis, demonstrates promising therapeutic potential for anxiety through the regulation of the mesolimbic dopamine system. Previous studies have revealed that cannabidiol infusions into the NAc decreases mesolimbic dopamine activity - potentially through the inhibitory GABA signaling to the VTA. However, the receptor mechanism in the NAc through which CBD produces its effects is …

Assessment Of Interprofessional Team Collaboration Scale (Aitcs): Further Testing And Instrument Revision., Carole Orchard, Linda L Pederson, Emily Read, Cornelia Mahler, Heather Laschinger

Nursing Publications

INTRODUCTION: The need to be able to assess collaborative practice in health care teams has been recognized in response to the direction for team-based care in a number of policy documents. The purpose of this study is to report on further refinement of such a measurement instrument, the Assessment of Interprofessional Team Collaboration Scale (AITCS) first published in 2012. To support this refinement, two objectives were set: Objective 1: to determine whether the items from the data collected in 2016 load on the same factors as found for the 2012 version of the 37-item AITCS. Objective 2: to determine whether …

A Review Of The Pharmacological And Clinical Profile Of Newer Atypical Antipsychotics As Treatments For Bipolar Disorder: Considerations For Use In Older Patients., Akshya Vasudev, Sumit Chaudhari, Rickinder Sethi, Rachel Fu, Rachel M Sandieson, Brent P Forester

Psychiatry Publications

Bipolar disorder prevalence rates vary in the older adult population (defined as age ≥ 65 years), ranging from 1% in community dwellers to as high as 8-10% in hospital inpatients. Although older agents, including lithium and valproic acid, offer significant antimanic efficacy, as supported by a recent randomized controlled trial (RCT), there is growing interest in using atypical antipsychotics to treat bipolar disorder in older adults. Newer atypical antipsychotics are of interest based on their tolerability and efficacy in the general adult bipolar population. The aim of this review was to systematically examine efficacy and tolerability of newer atypical antipsychotics …

Multisensory Integration And Autistic Traits Using Non-Sociolinguistic Information, Sébastien A. Lauzon, Samantha E. Schulz, Zack I. Cohen, Ryan A. Stevenson

Western Research Forum

Background: Sensory processing issues are one of the most common complaints in autism spectrum disorder (ASD). One area of sensory difficulties in ASD that has been the focus of intense research in recent years is multisensory integration (MSI), or the ability to bind auditory and visual information into a single, unified percept. While integration of social or linguistic information is consistently shown to be an area of difficulty in ASD, results are less clear with simple, non-sociolinguistic stimuli. This study aims to address this ambiguity by determining whether MSI of non-sociolinguistic sensory information is related to traits and symptomatology …

Parental Quality Of Life 10 Years After Their Child’S Epilepsy Diagnosis, Klajdi Puka, Kathy Nixon Speechley

Western Research Forum

Background: Although the long-term course of childhood epilepsy is favorable in terms of seizure control, patients often face debilitating cognitive and psychosocial deficits that persist even after seizure remission. Pediatric epilepsy also has a large impact on the family and has been shown to be associated with diminished quality of life (QOL) among parents. However, the long-term outcome of parental QOL is unknown. This study aimed to 1) evaluate parental QOL 10 years after their child was diagnosed with epilepsy and 2) identify epilepsy-, child- and family-related characteristics associated with diminished parental QOL.

Methods: Data were derived …

Music Therapy In Patients With Dementia And Behavioral Disturbance On An Inpatient Psychiatry Unit: Results From A Pilot Randomized Controlled Study., Joanna Thornley, Hussein Hirjee, Akshya Vasudev

Psychiatry Publications

The prevalence of dementia continues to grow worldwide due to an aging population and is projected to affect 65.7 million people by 2030 (World Health Organization, 2012). Behavioral and psychological symptoms of dementia (BPSD), including agitation, anxiety, aggression, depression, and psychosis, can occur in as much as 80% of the affected population, frequently necessitating psychiatric admission. Traditionally BPSD have been treated using pharmacological approaches. However, such medications could have serious adverse effects and additionally have limited efficacy in reducing such symptoms (Ballard et al., 2009).

A Training Programme Involving Automatic Self-Transcending Meditation In Late-Life Depression: Preliminary Analysis Of An Ongoing Randomised Controlled Trial., Akshya Vasudev, Amanda Arena, Amer M Burhan, Emily Ionson, Hussein Hirjee, Pramudith Maldeniya, Stephen Wetmore, Ronnie I Newman

Psychiatry Publications

: Late-life depression affects 2-6% of seniors aged 60 years and above. Patients are increasingly embracing non-pharmacological therapies, many of which have not been scientifically evaluated. This study aimed to evaluate a category of meditation, automatic self-transcending meditation (ASTM), in alleviating symptoms of depression when augmenting treatment as usual (NCT02149810). The preliminary results of an ongoing single-blind randomised controlled trial comparing a training programme involving ASTM with a wait-list control indicate that a 12-week ASTM programme may lead to significantly greater reductions in depression and anxiety severity. As such, ASTM may be an effective adjunctive therapy in the treatment of …

Trends In Psychotropic Dispensing Among Older Adults With Dementia Living In Long-Term Care Facilities: 2004-2013., Akshya Vasudev, Salimah Z Shariff, Kuan Liu, Amer M Burhan, Nathan Herrmann, Sean Leonard, Muhammad Mamdani

Psychiatry Publications

OBJECTIVE: Guidelines worldwide have cautioned against the use of antipsychotics as first-line agents to treat neuropsychiatric symptoms of dementia. We aimed to investigate the changes over time in the dispensing of antipsychotics and other psychotropics among older adults with dementia living in long-term care facilities.

METHODS: We used drug claims data from Ontario, Canada, to calculate quarterly rates of prescription dispensing of six psychotropic drug classes among all elderly (≥65 years of age) long-term care residents with dementia from January 1, 2004, to March 31, 2013. Psychotropic drugs were classified into the following categories: atypical and conventional antipsychotics, non-sedative and …

Behavioural Charactertics Of Patients Vulnerable For Repeated Hospitalisation, Amresh Srivastava, Coralee Berlmont, Miky Kaushal, Avinash Desouza, Robbie Campbell, Larry Stitt

Data and Test Instruments

Background Re-hospitalization which takes place in about 30 to 50% postdischarge patienst, leads to poor outcome, increased rate of mortality and consumes more than 2/3 of budgetary allocations. Inability to identify vulnerable candidates for repeated admissions limits our options for strategic treatment. Methods In this prospective study conducted at Regional Mental Health Care ( Presently Parkwood Institute) 101 patienst ( 51 feamles, mean age 43 years), were examined using standard psychometric tools on parameters of clinical, psychopathological, suicide behaviour and resiliency for their risk and preventive characerstics. Results We assessed 101 subjects (51 females) with mean age of 42 years. …

Brain Maturation, Poverty And Social Exclusion: Shifting Paradigms Of Psychopathology, Amresh Srivastava

Psychiatry Presentations

Abstract for lecture

Poverty is a major risk factor for mental disorders. Neuroimaging studies show path are breaking findings to explain why ppeople living in poverty suffer from improper development and maturation of brain due to neuronal loss. It sets in much before the child is born and leads to increased vulnerability for mental disorders.

Recent findings show that changes in brain structure and function due to lack of brain maturation is directly related to poverty. A number of these changes are end result of neuronal survival in the most fundamental neuronal matrix. These findings along with other biological correlates …

Should Suicide Behaviour Be An Outcome Parameter For Mental Disorder, Amresh Srivastava

Data and Test Instruments

Suicide and mental illness are closely related to each other. A high number of people who commit suicide suffer from a mental illness, and a high number of mentally ill patients exhibit suicide behavior. Suicide behavior is a significant aspect of mental illness. It is consistently observed throughout the course of illness, seen in the prodromal stage, during acute phase of remission, in residual phase and whenever illness relapses. A number of times, mental disorder improves but suicide behavior persists. 10-15% patients attempt suicide in the initial phase of an illness. More than half of the patients get hospitalized due …

Severe Mental Illnesses: Training And Education, Amresh Srivastava

Psychiatry Publications

Amresh Srivastava

MD,MRCPsych,FRCPC

Associate Professore of Psychiatry

Western University

London.ON

Severe Mental Illnesses: Training and Education

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About 4% patients in the community suffer from severe mental illness and about 16% from ‘any mental disorder’

Maximum financial and human resource allocations for mental health is consumed in managing severe mental disorders, leaving very little for treatment of early phase of illness and for developing preventive program.

All of us, psychiatrists, family physicians, other mental health professionals like, nurse, psychologists, socal workers, occupational therapists, counsellors, and members of advocacy groups and mental health organisations, face the challenge for managing patients who …

The Flip-Side To Readmission: Focused After-Care, Amresh Srivastava

Data and Test Instruments

paper 1. Suicidality in hospitalized early psychosis patients at time of discharge The purpose of this study was to investigate the presence and nature of suicidal risk among early psychosis patients at the time of discharge from hospital. Is it only related to the involvement of a suicidal attempt at admission? Thirty such patients, who were admitted after a suicide attempt were compared with 30 patients similarly diagnosed, but admitted for clinical reasons not involving a suicide attempt. Dependent measures of psychopathology, adjustment and suicidality were used. It was found that the two groups did not differ in suicidality, which …

Resilience : An Independent Psychobiological Mental Health Construct (Guest Editorial), Amresh Srivastava

Data and Test Instruments

Survival against trauma is a unique characteristic of all human beings. While a number of factors contribute in building this capacity, resilience appears to be the most important one. Interest in studying resilience arises from number of areas which are of utmost clinical significance such as such as exploring the possibility of at-risk individuals who developing a mental illness]. Resilience is a human capacity to adapt swiftly and successfully to stressful or traumatic events and revert back to a positive state. It is commonly conceptualized as the ability to thrive despite experiencing adversity

The Epidemic Of Mental And Neurological Health, Mohsyn I. Malik

Psychology Publications

This paper composes an image of modern mental and neurological health issues and looks to draw links to the current epidemic based on research and studies found online the internet and off-line. The goal is to examine what may be the underlying problem for a lot of these increases in mental health issues and neurodegenerative diseases and what are some promising clinical and sociocultural advances that may help. It explores problems such as the negative impact of the pharmaceutical giants, the increase in apathy in the work place and the general stigma towards mental disease. Through current research, the use …

Olanzapine-Induced Methylation Alters Cadherin Gene Families And Associated Pathways Implicated In Psychosis, Melkaye G. Melka, Christina A Castellani, Nagalingam Rajakumar, Richard O'Reilly, Shiva M Singh

Biology Publications

BACKGROUND: The complex aetiology of most mental disorders involves gene-environment interactions that may operate using epigenetic mechanisms particularly DNA methylation. It may explain many of the features seen in mental disorders including transmission, expression and antipsychotic treatment responses. This report deals with the assessment of DNA methylation in response to an antipsychotic drug (olanzapine) on brain (cerebellum and hippocampus), and liver as a non-neural reference in a rat model. The study focuses on the Cadherin/protocadherins encoded by a multi-gene family that serve as adhesion molecules and are involved in cell-cell communication in the mammalian brain. A number of these molecules …

The Co-Occurrence Of Ptsd And Dissociation: Differentiating Severe Ptsd From Dissociative Ptsd, Cherie Amour, Karen-Inge Karstoft, Don Richardson

MacDonald Franklin OSI Research Centre

Purpose

A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD.

Methods

The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity …

Improving Trainee Psychiatrist’S Handover: Standard Setting And Audit, Arun Gupta, Ruth Bevan, Akshya Vasudev

Psychiatry Publications

No abstract provided.

A New Brief Scale To Assess Suicidality: Scale For Impact Of Suicidality-Management, Assessment And Planning Of Care (Sis-Map- Brief Scanner), Amresh Srivastava, Megan Johnston, Miky Kaushal, Robbie Campbell, Charles Nelson

Data and Test Instruments

Purpose: In this study we examine merit of a short version (Brief Interview Screener (SIS-MAP-scn )of a previously developed and validated 108 item scale, known as ‘ Scale for Impact of Suicidality-Management, Assessment and Planning of Care ( SIS MAP), for rapid assessment in challenging clinical settings e.g. primary care and emergency room. Background: Generally suicide risk is assessed clinically and structured assessments optimize the direction for decision-making across various settings e.g. inpatient care, emergency rooms and crisis centers. We believe that measures with accurate and valid information should be based upon multifactorial risk-constituent domains, e.g. biological, social, psychological, environmental …

Dsm V: Hope Or Hype?, Amresh Srivastava

Data and Test Instruments

DSM V: HOPE OR HYPE? Amresh Shrivastava, MD,MPM,MRCPsych,FRCPC Associate professor of Psychiatry Western University London, Ontario Since more than 50 years psychiatric diagnostic is being developed by a number of organisations. As research has advanced in understanding mental illnesses,need for a common language has been felt in order to provide best possible care to our patients. The process of psychiatric diagnosis has evolved significantly. WHO as well APA both have made significant advances in developing diagnostic systems. DSM 5 recently approved by board of trustees by Americal psychiatric Association is scheduled to be released on 18th of May. This document …

Septohippocampal Gabaergic Neurons Mediate The Altered Behaviors Induced By N-Methyl-D-Aspartate Receptor Antagonists., Jingyi Ma, Siew Kian Tai, L Stan Leung

Physiology and Pharmacology Publications

We hypothesize that selective lesion of the septohippocampal GABAergic neurons suppresses the altered behaviors induced by an N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine or MK-801. In addition, we hypothesize that septohippocampal GABAergic neurons generate an atropine-resistant theta rhythm that coexists with an atropine-sensitive theta rhythm in the hippocampus. Infusion of orexin-saporin (ore-SAP) into the medial septal area decreased parvalbumin-immunoreactive (GABAergic) neurons by ~80%, without significantly affecting choline-acetyltransferase-immunoreactive (cholinergic) neurons. The theta rhythm during walking, or the immobility-associated theta induced by pilocarpine, was not different between ore-SAP and sham-lesion rats. Walking theta was, however, more disrupted by atropine sulfate in ore-SAP than …

Examining The Association Between Psychiatric Illness And Suicidal Ideation In A Sample Of Treatment-Seeking Canadian Peacekeeping And Combat Veterans With Posttraumatic Stress Disorder, Don Richardson, Kate St. Cyr, Alexandra M. Mcintyre-Smith, David Haslam, Jon D. Elhai, Jitender Sareen

MacDonald Franklin OSI Research Centre

Objective:

Our study examines the association between suicidal ideation and and self-reported symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and alcohol use disorder (AUD) in a sample of treatment-seeking Canadian combat and peacekeeping veterans; and identifies potential predictors of suicidal ideation.

Methods:

Actively serving Canadian Forces and Royal Canadian Mounted Police members and veterans seeking treatment at the Parkwood Hospital Operational Stress Injury Clinic (n = 250) completed measures including the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, the Alcohol Use Disorder Identification Test, and the PTSD Checklist—Military Version (PCL-M) …

Baseline Serum Prolactin In Drug-Naive, Firstepisode Schizophrenia And Outcome At Five Years: Is It A Predictive Factor?, Amresh Srivastava, Megan Johnston, Yves Bureau, Nilesh Shah

Data and Test Instruments

Objective: Serum prolactin is influenced by antipsychotic use but its relationships with psychopathology and general functioning are not clear. This study aimed to assess these relationships. Design: Serum prolactin levels were measured in patients with schizophrenia before being treated with antipsychotics and at various follow-up points. Setting: The study was conducted in a nongovernmental psychiatric treatment center in Mumbai, India. Participants: The participants included 30 male and 30 female drug-naïve patients with schizophrenia and 31 control participants. Measurements: The severity of psychopathology at baseline, three weeks, six weeks, and five years following treatment was assessed using a modified Brief Psychiatric …

Early Intervention Of Psychosis And Re! Ections For Programmes In India, Amresh Srivastava

Data and Test Instruments

Mental illness is perhaps the most common and most debilitating among non-communicable diseases. Schizophrenia, for example, normally occurs before the age of 25, affect the most productive years of life. The World Economic Forum graphically illustrates that mental illnesses will be a major contributor to the erosion of gross domestic product over the next 20 years. The developed world has established programs that have proven to be clinically and economically effective and sustainable.[1] Early intervention has played an important role in demonstrating that outcome can be improved if patients are treated in the early phase of illness. It is believed …