Canadian journal of psychiatry. Revue canadienne de psychiatrie
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Obesity is associated with early mortality and has overtaken smoking as the health problem with the greatest impact on quality of life, mortality, and morbidity. Despite public health initiatives and numerous commercial enterprises focusing on weight loss, obesity rates continue to rise. In part, this is because obesity is a multifaceted, complex illness, impacted by numerous social, psychological, and behavioural factors that are unrecognized in most current initiatives. ⋯ While having a psychiatric illness does not make weight gain inevitable, it does often require that additional tools be added to lifestyle recommendations around diet and exercise. The following article reviews the common approaches to obesity management and addresses how these strategies can be implemented in psychiatric care. It is important that health professionals involved in the care of people with a mental illness become familiar with the interventions available to control and treat the obesity epidemic, as this will improve treatment compliance and ultimately lead to improved physical and psychological outcomes.
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Multicenter Study
Emergency department assessment of self-harm risk using psychometric questionnaires.
To examine several potential predictive screening tools for emergency department assessment of risk of self-harm. ⋯ While many of the questionnaires and their related constructs are related to future self-harm, none of them are particularly strong and their diagnostic usefulness is limited.
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Meta Analysis Comparative Study
A meta-analysis of the efficacy of pregabalin in the treatment of generalized anxiety disorder.
Generalized anxiety disorder (GAD) is a chronic anxiety disorder that leads to significant functional impairment and reduced quality of life. Pregabalin is a novel analogue of the inhibitory neurotransmitter gamma amino butyric acid, which has been proposed as a treatment for a range of conditions including GAD. This study examined the efficacy of pregabalin for GAD across published trials, using a meta-analytic method. ⋯ Pregabalin is an efficacious therapy for GAD, although effect sizes are smaller than those from earlier studies. Limitations and future research directions are discussed.
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Review
Nonmedical prescription opioid use and mental health and pain comorbidities: a narrative review.
In North America, the prevalence of nonmedical prescription opioid use (NMPOU), and morbidity and mortality related to prescription opioid analgesics (POAs) has risen sharply. Epidemiologic studies have suggested a high prevalence of mental health and pain comorbidities in NMPOU samples. Given the potential importance for interventions, a narrative review was conducted on studies reporting data on the co-occurrence of NMPOU with mental health problems and pain symptoms in general, treatment, or special populations. ⋯ The extensive associations observed between NMPOU and mental health and pain comorbidities suggest that effective preventive or treatment interventions for NMPOU must consider and attend to these comorbidities. As POAs are widely available and used in North America, POAs may increasingly be used in nonmedical ways for pain or mental health problems not effectively diagnosed or treated.
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People hospitalized for depression are often discharged before the acute phase of their illness has resolved and need timely care transitions to prevent relapse. We examined 30-day postdischarge service use for Ontarians, aged 15 years or older, who were hospitalized for depression. We focused on a pattern consistent with guideline and policy directions: higher rates of physician visits, postdischarge, combined with lower rates of emergency department (ED) admissions or rehospitalization. ⋯ One-third of Ontarians hospitalized for depression did not receive recommended follow-up outpatient care within 30 days of discharge and one-quarter received follow-up through ED visits or readmissions, highlighting the need to improve coordination and integration across care settings for these patients. There are tested transitional and outpatient models that improve quality and outcomes of depression care that merit serious consideration.