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The purpose of the current study was to explore whether selfcompassion predicted psychological distress over and above childhood maltreatment and attachment orientation in high-risk youths. Fifty-one youths (31 males, 20 females) aged 17 to 24, recruited from a community non-profit organization in St. John's, Newfoundland and Labrador, Canada, were administered validated measures of childhood maltreatment, attachment orientation, self-compassion, and psychological distress. Results indicated that self-compassion was inversely associated with childhood maltreatment, attachment anxiety, attachment avoidance, and psychological distress. However, results did not support the hypothesis that self-compassion was a significant predictor of psychological distress over and above attachment anxiety and childhood maltreatment in high-risk youths. Our results indicated that self-compassion is not well developed in street-involved youths and may be a vital intervention target to heal negative internalized views of the self, while maintaining vigilance to threats inherent in the street environment.

This study examined the cross-lagged relationships between students' autonomous motivations (intrinsic motivation and identified regulations) and approach goals (mastery and performance) in school. The sample included 449 students (52% girls) in Grades 7 and 8 (secondary 1 and 2). Results showed that intrinsic motivation (IM) positively predicted approach goals 20 months later, while mastery-approach goals (MAp) positively predicted autonomous motivations. A second objective was to test the contributions of autonomous motivations and approach goals to students' school functioning measured 32 months after the beginning of the study. Five main findings can be highlighted: IM contributed to (1) increased academic achievement (via high MAp and PAp), (2) increased social anxiety (via high PAp), and (3) decreased disruptive behaviours (via high MAp); MAp goals predicted (4) a decreased in disruptive behaviours (via high identified regulation) and (5) increases in achievement (via high IM). Implications for education stakeholders are presented.

Course grades, as an indicator of academic performance, are a primary academic concern at the secondary school level and have been associated with various aspects of mental health status. The purpose of this study is to simultaneously assess whether symptoms of mental illness (depression and anxiety) and mental well-being (psychosocial well-being) are associated with self-reported grades (in their primary language [English or French] and math courses) and education behaviors (school days missed due to health, truancy, and frequency of incomplete homework) in a sample of secondary school students across Canada (n = 57,394). Multivariate imputation by chained equations and multilevel proportional odds logistic regressions were used to assess associations between mental health scores, academic performance and education behaviors. Lower depression and higher psychosocial well-being scores were associated with better grade levels in both math and language courses, as well as better education behaviors. In turn, better education behaviors were associated with higher course grades. Depression scores and psychosocial well-being scores remained associated with higher grades after controlling for education behaviors, however the magnitude of association was diminished. Results indicate that the effects of mental health factors were partially attenuated by education behaviors, suggesting while reduced class attendance and poor homework adherence were associated with both academic outcomes and mental health, they do not account entirely for the association between lower grades and worse mental health.

The current study evaluated the validity and reliability of the SCARED on a Native American child population. Results suggest excellent internal consistency for the total score. The hierarchical model best fit the data. Overall the SCARED is a valid tool for identifying Native American children at-risk for developing anxiety disorders.

Purpose: To examine the effects on anxiety of mindfulness-based interventions (MBIs) among youth with anxiety disorders. Method: Systematic review and meta-analytic procedures were employed to synthesize experimental and quasi-experimental studies authored between 1980 and 2015. Results: The search yielded five studies from five countries reporting results for a total of 188 youth between the ages of 5 and 18 (mean age 13.26) who met criteria for an anxiety disorder. Risk of bias varied across studies. Meta-analytic results suggest a moderate and significant effect (g = 0.62; 95% confidence interval = [0.20, 1.04], p = 0.004). Heterogeneity was moderate (I2= 47.22) and not statistically significant (Q = 7.58, df = 4, p = 0.11), thus moderator analyses were not warranted. Discussion: The findings of this review suggest that MBIs for the treatment of anxiety in youth with anxiety disorders are effective.

Staff at campus-based counselling and disability centres in 15 of Ontario's 24 community colleges completed 3,536 surveys on 1,964 individual students querying the presence of mental illness and academic challenges as reported by students accessing these services. Survey data were analyzed to determine prevalence rates of mental disorders and investigate for the presence of a relationship between specific mental illnesses and any associated academic impacts. More than half of these students had diagnoses with mood and anxiety disorders being the most common individual and comorbid diagnoses. The academic challenges reported by students with mental illnesses occurred in particular patterns relative to specific diagnoses; alertness/attention challenges were associated with mood disorders, whereas memory/executive function problems were linked to anxiety disorders. Implications for training and service practices of counselling and disability staff are reviewed as are future research directions for accommodating the academic needs of students with mental illnesses.

Worldwide, prevalence rates of students experiencing mental health difficulties are growing, with only one in five receiving treatment. The role of teachers in collaborative efforts both to identify and to provide effective services for these students is an essential one. However, scant research has explored the mental health literacy of pre-service teachers. In the present study, 186 pre-service teachers completed a vignette-based measure (Child or Adolescent version based on each teacher's experience) in order to assess their mental health literacy, comprised of beliefs and knowledge. Results indicate that participants expressed lower efficacy when teaching children or adolescents with externalizing as compared to internalizing behaviours but believed that a child or adolescent experiencing behaviours indicative of depression was of the greatest concern and in need of intervention. Pre-service teachers were able to correctly identify cases of anxiety and ADHD, but many attributed behaviours typical of depression to home life difficulties (Child version) or substance use/abuse (Adolescent version). Results are discussed in light of previous research in the field; recommendations for future research and practice are provided.

Previous research linking school disruption with mental health problems has largely relied on assessments of academic achievement to measure school disruption. Early disruptive classroom behaviour (e.g., conflict with school staff, negative attitudes toward school), however, may precipitate poor academic performance and may stem from emerging mental health concerns, particularly among young children. To address this gap in the literature, 912 clinically referred children and youth (ages 4-18 years old) were assessed using the interRAI Child and Youth Mental Health (ChYMH) assessment utilizing a cross-sectional study design. The ChYMH assessment evaluates school disruption independently of academic achievement, and includes a comprehensive assessment of the child's mental health functioning, needs, and preferences. A logistic regression analysis revealed that various provisional mental health diagnoses (i.e., attention-deficit/hyperactivity disorder, disruptive behaviour, mood disorders, and, to a lesser extent, anxiety) were associated with disruption in the classroom. Implications for school-based care planning are discussed.

Selective mutism (SM) is a childhood disorder characterized by failure to speak in social situations, despite there being an expectation to speak and the capacity to do so. There has been a focus on elucidating the differences between SM and anxiety disorder (ANX) in the recent literature. Although children with SM exhibit more symptoms at school than at home, the assessment of SM typically does not involve teacher reports. There is also a lack of research to help us better understand how to best support students with SM in the classroom, and linking assessment to intervention. The "Teacher Telephone Interview: Selective Mutism and Anxiety in the School Setting" (TTI-SM) was developed by a group of researchers across three large children's hospitals in Canada, within specialized ANXs Clinics, with the goal of addressing several of these diagnostic and treatment issues. Child participants (ages 6-11) were referred for SM (n = 19) or ANX (n = 10). Findings revealed that the SM subscale of the TTI-SM has acceptable psychometric properties. Scores on the SM subscale between the two groups of children were statistically significant t(29) = -3.67, p < 0.001, ?[superscript2] = 0.33, suggesting that the SM subscale was able to distinguish between children with SM and ANX. Given the promising findings, and possible uses of this tool for assessment and intervention, the TTI-SM warrants further research. The role of the teacher in the assessment of children with SM and anxiety disorders, and future directions are discussed.

Based on clinical experience, we hypothesized that rigid-compulsive behaviors are associated with severe constipation and co-occurring diarrhea or underwear staining in children with autism spectrum disorder. Using data from the Autism Treatment Network, we evaluated the association between these gastrointestinal symptoms and measures of rigid compulsive behavior in children ages 2-17. Following statistical correction, four of five primary measures were significantly associated with constipation and diarrhea or underwear staining, including parental report of repetitive behavior, parental report of compulsive behavior, clinician diagnosis of obsessive-compulsive disorder, and report of rituals observed on the autism diagnostic observation schedule. This association could point to a causal connection between these symptoms or to a common biological pathway that impacts both gut and brain.

Objective: To estimate the prevalence of current psychiatric disorders among children and adolescents (collectively called children) of mothers entering treatment for depression; to examine maternal predictors of child psychopathology among children of depressed mothers; and to determine consistency of findings with a similar child study ancillary to Sequenced Treatment Alternatives to Reduce Depression (STAR*D) from seven United States sites (STAR*D-Child). Method: Mothers (N = 82) with major depressive disorder (MDD) enrolled in a treatment study in Ottawa (Ontario, Canada) or New York City, and their eligible children (N = 145) (aged 7 through 17 years) were assessed independently when the mother enrolled. Results: Among the children of depressed mothers, 42% had at least one current psychiatric diagnosis, including affective (15%), anxiety (19%), behavioral (23%), and/or substance use (2%) disorders. In all, 40% of the children were rated as impaired by clinical assessors. Mothers' comorbid anxiety disorders predicted the highest rates of current disorders in the child in both studies. The severity of the mother's depression predicted behavioral problems in the child. The current and lifetime rates of psychiatric disorders in the children of depressed mothers were compared to rates found in STAR*D Child and findings were consistent. Both studies used similar diagnostic assessments. Conclusion: Given the high prevalence of offspring psychiatric disorders, inquiring about the mental health of the children when a depressed mother comes for treatment, and referring children for treatment when appropriate, are important. (Contains 6 tables.)

This study investigated childhood physical abuse and ulcers in a regionally representative community sample. Age, race and sex were controlled for in addition to five clusters of potentially confounding factors: adverse childhood conditions, adult socioeconomic status, current health behaviors, current stress and marital status, and history of mood/anxiety disorders. Childhood physical abuse is associated with many negative physical and psychological adult health outcomes. Two recent studies demonstrate a potential link between childhood physical abuse and peptic ulcer disease in adulthood. The authors use regional data for the Canadian provinces of Manitoba and Saskatchewan from the 2005 Canadian Community Health Survey. Of the 13,069 respondents with complete data on abuse and ulcers, 7.3% (n = 1,020) report that they had been physically abused as a child by someone close to them and 3.0% (n = 493) report that they had been diagnosed with peptic ulcers by a health professional. The regional response rate is approximately 84%. Findings show that those reporting abuse had more than twice the prevalence of ulcers than did those not reporting abuse (6.6% vs. 2.7%). The fully adjusted odd ratio of peptic ulcers among those who had reported childhood physical abuse is 1.68 (95% CI = 1.22, 2.32). A significant and stable relationship between childhood physical abuse and peptic ulcers is found, even when taking into account five clusters of potentially confounding factors. Prospective studies that apply the biopsychosocial model are likely to be the most effective for identifying the pathways that connect childhood physical abuse and ulcer disease. (Contains 1 table and 1 figure.)

We investigated the interaction effects between mother's lifetime depressive/anxiety disorders and psychosocial correlates of 6 to 11 year-old children's self-reported externalizing symptoms in the Quebec Child Mental Health Survey. A representative subsample of 1,490 Quebec children aged 6 to 11 years was selected from the original sample. We conducted multiple linear regression analyses using externalizing symptoms as reported by children through the Dominic questionnaire and multiple child, family and socioeconomic characteristics. Two variables interacted significantly with mother's lifetime depressive/anxiety disorders to predict 6 to 11 year-old children's self-reported externalizing symptoms: physical/sexual abuse and mother's caring behaviours. Results underline the main contribution of mother-child relationship and stressful events in the association between mother's lifetime depressive/anxiety disorders and children's externalizing symptoms. It is suggested to develop preventive intervention programs oriented towards children of lifetime depressed/anxious parents who also report parent-child relational difficulties.

Many individuals with intellectual disabilities who live with their families experience mental health problems and ensuing psychiatric emergencies. During periods of crisis, families may require additional services, including going to the emergency department (ED). The goal of this study was to elucidate demographic, clinical, and crisis features associated with ED use in 192 individuals who lived with family and experienced a psychiatric crisis. The presence of psychiatric symptoms; a mild (vs. moderate/severe) level of intellectual disability; a history of behavior problems, psychiatric hospitalization, and ED use; and a recent history of negative life events were related to ED use. Learning about the factors that distinguish groups is needed to make sure we develop proactive community-based resources for such people to prevent visits to the ED from occurring when possible. (Contains 4 tables.)

Intolerance of uncertainty (IU) is related to anxiety, depression, worry, and anxiety sensitivity. Precedent IU measures were criticized for psychometric instability and redundancy; alternative measures include the novel 45-item measure (Intolerance of Uncertainty Index; IUI). The IUI was developed in French with 2 parts, assessing general unacceptability of uncertainty (15 items, Part A) and manifestations of uncertainty approximating more common anxiety disorder symptoms (30 items, Part B). The psychometric stability of the back-translated English items of the IUI as well as the incremental variance of Parts A and B remain to be assessed. The current study involved 2 samples of English-speaking community participants (n = 437 and n = 309; 73% women and 27% men) who completed the IUI and several related measures. Exploratory and confirmatory factor analyses suggested a refinement of IUI items as well as a unitary structure for Part A and a 3-factor structure for Part B. Regression results suggested Parts A and B each provide incremental validity in measures of worry, generalized anxiety disorder symptoms, negative problem orientation, and depression. Comprehensive results, implications, and future research directions are discussed. (Contains 6 tables.)

Background: This study examines the use of the Brief Child and Family Phone Interview (BCFPI) to screen for childhood psychiatric disorder based on Diagnostic Interview Schedule for Children Version IV (DISC-IV) classifications of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety (SAD), generalized anxiety (GAD) and major depression (MDD). Methods: Data for analysis come from a sample of 399 children and adolescents aged 5-17 years old referred to child mental health outpatient services in three Ontario cities. Mothers were administered the BCFPI on three occasions: baseline, 2 and 13 months; and the DISC-IV on two occasions: 1 and 12 months. Results: Based on kappa, test-retest reliability for disorders classified by the BCFPI exceeded 0.50 for all conditions except MDD (0.45). In receiver operating characteristic (ROC) analysis, area-under-the-curve (AUC) estimates for BCFPI scale score associations with DISC-IV classifications of disorder exceeded 0.80 for CD, ODD, ADHD and SAD; and were lower for GAD (0.76) and MDD (0.75). In stratified analyses, there were no statistically significant differences in AUC estimates for boys versus girls and 5 to 11 versus 12 to 17-year-olds. Conclusions: Classifications of childhood disorder derived from the BCFPI provided a reasonable approximation to disorders classified by the DISC-IV administered by lay interviewers.

Background: This study describes the development of the Brief Child and Family Phone Interview (BCFPI)--a computer-assisted telephone interview which adapts the revised Ontario Child Health Study's (OCHS-R) parent, teacher, and youth self-report scales for administration as intake screening and treatment outcome measures in children's mental health services. It focuses on the factor structure of the BCFPI's hypothesized parent-reported child mental health scales describing attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety disorder (SAD), generalized anxiety disorder (GAD), and major depression (MDD). Methods: Data for the analysis come from an OCHS-R measurement study that included two groups of children and adolescents selected from the same urban area: a general population sample (n = 1,712) and a clinic-referred sample (n = 1,512); and a third sample that was enlisted in a province-wide implementation study of clinic-referred 6- to 18-year-olds (n = 56,825). We used confirmatory factor analysis to assess the factor structure of the BCFPI scales in different populations and to test measurement equivalence across selected groups. Results: Despite the strong constraints imposed on the measurement models, estimates of model fit across the three samples were comparable in magnitude and approached the cut-offs suggested for the GFI and CFI (greater than 0.9) and RMSEA (less than 0.05). Measurement equivalence was demonstrated between the OCHS-R clinic and provincial implementation samples. Within the implementation sample, the factor structure of the BCFPI scales was equivalent for boys versus girls and for 6- to 12- versus 13- to 18-year-olds. A companion paper examines the test-retest reliability, sensitivity, specificity, and validity of these BCFPI scales when used for screening. Conclusion: This project supports the feasibility and acceptability of a computer-assisted telephone interview for assessing emotional-behavioral problems of children and adolescents referred to children's mental health services.

We examined receptive language and academic abilities in children with selective mutism (SM; n = 30; M age = 8.8 years), anxiety disorders (n = 46; M age = 9.3 years), and community controls (n = 27; M age = 7.8 years). Receptive language and academic abilities were assessed using standardized tests completed in the laboratory. We found a significant group by sex interaction for receptive vocabulary scores such that, within females, the SM and mixed anxiety groups had significantly lower receptive vocabulary scores than community controls. We also found that children with SM and children with anxiety disorders had significantly lower mathematics scores than community controls. Despite these differences in mathematics and receptive vocabulary performance, children with SM and children with anxiety disorders still performed at age-level norms, while more children in the community control group performed above age-level norms. Findings suggest that despite their speaking inhibition in the school setting, children with SM are still able to attain the receptive vocabulary and academic abilities that are expected at their age levels. (Contains 2 figures, 3 tables, and 3 notes.)

We evaluated a novel, computerized feelings assessment instrument (MAAC) in 54 children with anxiety disorders and 35 nonanxious children ages 5 to 11. They rated their feelings relative to 16 feeling animations. Ratings of feelings, order of feeling selection, and correlations with standardized anxiety measures were examined. Positive emotions were rated more highly and visited earlier by nonanxious children. Children with anxiety disorders explored fewer emotions. MAAC ratings on several positive emotions showed inverse correlations with state anxiety. Although needing further evaluation, MAAC may facilitate feelings assessment in young children and may distinguish children with anxiety disorders from nonanxious children. (Contains 2 tables.)

Summary: Background: Internalized weight bias (IWB) has been identified as a correlate of higher depressive and anxiety symptoms in adolescents with higher weights. However, there has been limited investigation into how IWB relates to positive mental health and whether these associations differ across genders. Objectives: To examine the associations between IWB and mental health (depression, anxiety, flourishing) in adolescents with higher weights, and to test the potential moderating role of gender. Methods: Canadian adolescents with higher weights (N = 7538, 60% boys, 36% girls, 4% gender diverse, ages 12–19) from the COMPASS study completed a survey during the 2021–2022 school year. Data were analysed using generalized linear models. Results: Highest IWB and poorest mental health were noted within gender diverse adolescents, followed by girls then boys. Gender moderated the relationship between higher IWB and higher depression, higher anxiety and lower flourishing, with the strongest relationships noted among girls. Conclusion: IWB interventions should be tailored to gender subgroups that may be particularly vulnerable to maladaptive mental health outcomes associated with IWB. System‐level changes that mitigate perpetuation of weight bias and discrimination which lead to IWB are also essential, particularly for girls. [ABSTRACT FROM AUTHOR]

Background: The rising prevalence of mental and psychological issues among immigrants has garnered increased attention due to the significant growth in immigrant populations in recent years. In this context, exploring the connection between psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing in Iranian immigrants in Canada is becoming an essential research goal. Objectives: The aim of this study was to explore the relationships between psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing among Iranian immigrants in Canada. Methods: A cross-sectional study design was used, gathering data from 400 Iranian students (198 males and 202 females) enrolled at universities in Canada and Iran. We collected participants' demographic details and assessed their psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing through standardized instruments. Psychological health was evaluated using the Beck Anxiety Inventory, cognitive flexibility was measured with the Dennis and Vander Wall Cognitive Flexibility Questionnaire, and sensory processing was appraised via the adolescent/adult sensory profile. The Carver and White behavioral inhibition system (BIS)/behavioral activation system (BAS) scales were utilized to measure brain-behavioral systems. Statistical analyses, including correlation analysis and multivariate regression, were conducted to investigate the relationships among these variables. Results: The correlation analysis revealed significant positive associations between anxiety and low registration (r = 0.283, P < 0.001), sensory sensitivity (r = 0.442, P < 0.001), and sensory avoiding (r = 0.307, P < 0.001) in immigrant students. Anxiety also showed nonsignificant negative correlations with the behavioral activation system-drive (r = -0.042, P = 0.551) and behavioral activation system-reward responsiveness (r = -0.090, P = 0.203). The multivariate regression analysis found that low registration (B = 0.177, P = 0.036), sensory sensitivity (B = 0.336, P < 0.001), and cognitive flexibility (B = 0.119, P = 0.025) significantly predicted anxiety levels in immigrant students. An adjusted R-squared value of 0.191 indicated that these variables together explained 19.1% of the variance in anxiety levels. Conclusions: This study underscores the significant links between sensory processing patterns, cognitive flexibility, brain-behavioral systems, and anxiety among Iranian immigrant students. These findings highlight the need for interventions focusing on teaching cognitive skills strategies and increasing awareness of sensory needs to help reduce anxiety levels in this population. [ABSTRACT FROM AUTHOR]

Context: Mood and anxiety disorders appear to be overrepresented in adults with cardiovascular diseases (CVDs). These disorders have been associated with poorer biopsychosocial outcomes in this population. Mood and anxiety disorders often co-occur, but the prevalence of this comorbidity and their potential additive effects in patients with CVD remain understudied. Aims: This study aimed to estimate the prevalence and co-occurrence rates of mood and anxiety disorders in the general adult population living with CVD. Associations between mood and anxiety disorder status and sociodemographic characteristics, somatic comorbidities, perceived mental health, and health-care service use were also investigated. Methods: A total of 6,792 adults aged 25 years or older and living with CVD were selected from the 2015-2016 Canadian Community Health Survey. Mood and anxiety disorders were identified based on self-report diagnoses made by a qualified health professional. All other variables were assessed using questionnaires. Results: An estimated 17.7% of the studied population reported having been diagnosed with a mood or anxiety disorder. More precisely, 6.6% reported a mood disorder, 5.5% reported an anxiety disorder, and an additional 5.6% reported both. The presence of mood or anxiety disorders was associated with poorer perceived mental health and higher health-care service use, and these associations were stronger when mood and anxiety co-occurred. Conclusions: Approximately one in six adults with CVD reported suffering from mood or anxiety disorders, and a third of them presented both conditions. This study also suggests that co-occurring anxiety and mood disorders lead to greater vulnerability than either disorder in adults with CVD. [ABSTRACT FROM AUTHOR]

Objectives Contemporary immigration scholarship has typically treated immigrants with diverse racial backgrounds as a monolithic population. Knowledge gaps remain in understanding how racial and nativity inequities in mental health care intersect and unfold in midlife and old age. This study aims to examine the joint impact of race, migration, and old age in shaping mental health treatment. Methods Pooled data were obtained from the Canadian Community Health Survey (2015–2018) and restricted to respondents (aged ≥45 years) with mood or anxiety disorders (n = 9,099). Multivariable logistic regression was performed to estimate associations between race–migration nexus and past-year mental health consultations (MHC). Classification and regression tree (CART) analysis was applied to identify intersecting determinants of MHC. Results Compared to Canadian-born Whites, racialized immigrants had greater mental health needs: poor/fair self-rated mental health (odds ratio [OR] = 2.23, 99% confidence interval [CI]: 1.67–2.99), perceived life stressful (OR = 1.49, 99% CI: 1.14–1.95), psychiatric comorbidity (OR = 1.42, 99% CI: 1.06–1.89), and unmet needs for care (OR = 2.02, 99% CI: 1.36–3.02); in sharp contrast, they were less likely to access mental health services across most indicators: overall past-year MHC (OR = 0.54, 99% CI: 0.41–0.71) and consultations with family doctors (OR = 0.67, 99% CI: 0.50–0.89), psychologists (OR = 0.54, 99% CI: 0.33–0.87), and social workers (OR = 0.37, 99% CI: 0.21–0.65), with the exception of psychiatrist visits (p =.324). The CART algorithm identifies three groups at risk of MHC service underuse: racialized immigrants aged ≥55 years, immigrants without high school diplomas, and linguistic minorities who were home renters. Discussion To safeguard health care equity for medically underserved communities in Canada, multisectoral efforts need to guarantee culturally responsive mental health care, multilingual services, and affordable housing for racialized immigrant older adults with mental disorders. [ABSTRACT FROM AUTHOR]

The prevalence of anxiety disorders continues to increase in Canada. The study aimed to evaluate sex differences in the prevalence of anxiety disorders, associated identity factors and social determinants, and their interactions among the Canadian population. We used data from the 2017–2018 Canadian Community Health Survey (CCHS), a nationally representative survey. We evaluated associations between sex, other identity characteristics and social determinants, and anxiety disorders using multivariable logistic regression. To account for the complex sampling design, we applied sampling and bootstrap weights. The CCHS included 113,290 respondents, representative of 98% of the Canadian population over 12 years old. The prevalence of self-reported anxiety disorders was higher among females than males (11.6% vs 6.3%, p < 0.001). Adjusted regression analysis revealed higher odds of having mood disorders for those who were female, non-White, non-immigrant, homosexual or bisexual, unemployed, had lower income or food insecurity, had a disability and a weak sense of community belonging. Younger age was associated with higher odds of anxiety disorders among females (aOR: 1.50, 95%CI: 1.10–2.05) but not among males (aOR: 0.99, 95%CI: 0.64–1.56). An association between employment and higher income with lower odds of anxiety disorders, and bisexuality with higher odds of anxiety disorders, was stronger among males compared with females. Anxiety disorders are more prevalent among females than males in Canada. Age, employment, income, and sexual orientation have varying associations with anxiety disorders among the sexes. Strategies for improving mental health must recognize the complex links between sex and intersecting factors. • The prevalence of anxiety disorders in Canada is significantly higher among females. • The association of younger age with anxiety disorders is stronger among females. • Bisexuality has a stronger association with anxiety disorders among males. • Income is more strongly associated with anxiety disorders in males. [ABSTRACT FROM AUTHOR]

Background Weight status and weight perception have a significant impact on life satisfaction. As overweight prevalence increases in Canada, it is important to understand how accuracy of weight perception (AWP) is associated with life satisfaction. This study explored the association between AWP and life satisfaction among Canadian adults with and without anxiety and/or mood disorders. Methods Using data from the 2015–2018 cycles of the Canadian Community Health Survey, an indicator of AWP was created to capture concordance between perceived weight and actual weight status. Univariate and multivariate Gaussian generalized linear models were assessed while stratifying by sex and presence of anxiety and/or mood disorders. Results Our sample included 88 814 males and 106 717 females. For both sexes, perceiving oneself as overweight or underweight, regardless of actual weight status, was associated with lower life satisfaction (β = −0.93 to −0.30), compared to those who accurately perceived their weight as 'just about right'. Perceiving oneself as overweight or underweight was associated with more pronounced differences in life satisfaction scores in those with anxiety and/or mood disorders (β = −1.49 to −0.26) than in those without these disorders (β = −0.76 to −0.25). Conclusion Weight perception is more indicative of life satisfaction than actual weight status, especially in those with anxiety and/or mood disorders. [ABSTRACT FROM AUTHOR]

Objective: Psychiatric disorders, such as depression and anxiety, can hinder academic performance among college-age individuals. Participants: Mental health among college students is a growing public health concern, with some scholars describing collegiate mental health as a crisis (Chen et al., Psychiatr Serv. 2019;70(6):442–449). Methods: This study analyzes data from four annual administrations of the American College Health Association (ACHA)'S NCHA (n = 117,430). Results: Overall, anxiety and depression were the most common conditions, at 9.2% and 8.7%, respectively. Of students reporting the focal symptom, 17.87% were treated for depression and 12.91% were treated for anxiety. Compared to not-treated students, diagnosed only students, had significantly lower grade averages, with effect sizes of −0.30 and −0.20 for depression and anxiety, respectively. Conclusions: Given the prevalence of depression and anxiety among college-aged students, continued research into help seeking behaviors and their effects on outcomes like grade average is an essential part of understanding the toll these disorders take. [ABSTRACT FROM AUTHOR]

Research focusing on the role of adverse childhood experience (ACE) of individuals involved in sexual homicide (SH) is scarce. Theoretical models of SH have postulated a connection between these adverse experiences and the development of internal risk factors. However, such assumptions have never been empirically tested. Therefore, the current research aims to identify how ACEs affect the development of personality disorders and problematic behaviors during adolescence, which constitute internal risk factors for the commission of SH. The sample comes from a database including 613 individuals involved in sexual crimes in Canada among which 60 committed a SH. Bivariate and multiple regression analyses were conducted to identify personality disorders and problematic behaviors during adolescence associated with the presence of ACEs. Next, path analysis was used to identify the direct and indirect relationships between ACEs, internal risk factors, and the commission of SH. Results showed that individuals who experienced ACEs were more likely to develop internal risk factors involved in the commission of SH. Moreover, findings suggest that the impact of these adverse experiences will differ, depending on whether the child has been victim of violence or if he/she has witnessed it. [ABSTRACT FROM AUTHOR]

Anxiety disorders are the most common mental health concerns affecting Canadian children and adolescents. The Canadian Paediatric Society has developed two position statements that summarize current evidence regarding the diagnosis and management of anxiety disorders. Both statements offer evidence-informed guidance to support paediatric health care providers (HCPs) making decisions around the care of children and adolescents with these conditions. The objectives of Part 1, which focuses on assessment and diagnosis, are to: (1) review the epidemiology and clinical characteristics of anxiety disorders and (2) describe a process for assessment of anxiety disorders. Specific topics are reviewed, including prevalence, differential diagnosis, co-occurring conditions, and the process of assessment. Approaches are offered for standardized screening, history-taking, and observation. Associated features and indicators that distinguish anxiety disorders from developmentally appropriate fears, worries, and anxious feelings are considered. Note that when the word 'parent' (singular or plural) is used, it includes any primary caregiver and every configuration of family. [ABSTRACT FROM AUTHOR]

Objective: Serotonergic psychedelics are re-emerging as potential novel treatments for several psychiatric disorders including major depressive disorder. The Canadian Network for Mood and Anxiety Treatments (CANMAT) convened a task force to review the evidence and provide a consensus recommendation for the clinical use of psychedelic treatments for major depressive disorder. Methods: A systematic review was conducted to identify contemporary clinical trials of serotonergic psychedelics for the treatment of major depressive disorder and cancer-related depression. Studies published between January 1990 and July 2021 were identified using combinations of search terms, inspection of bibliographies and review of other psychedelic reviews and consensus statements. The levels of evidence for efficacy were graded according to the Canadian Network for Mood and Anxiety Treatments criteria. Results: Only psilocybin and ayahuasca have contemporary clinical trials evaluating antidepressant effects. Two pilot studies showed preliminary positive effects of single-dose ayahuasca for treatment-resistant depression (Level 3 evidence). Small randomized controlled trials of psilocybin combined with psychotherapy showed superiority to waitlist controls and comparable efficacy and safety to an active comparator (escitalopram with supportive psychotherapy) in major depressive disorder, with additional randomized controlled trials showing efficacy specifically in cancer-related depression (Level 3 evidence). There was only one open-label trial of psilocybin in treatment-resistant unipolar depression (Level 4 evidence). Small sample sizes and functional unblinding were major limitations in all studies. Adverse events associated with psychedelics, including psychological (e.g., psychotomimetic effects) and physical (e.g., nausea, emesis and headaches) effects, were generally transient. Conclusions: There is currently only low-level evidence to support the efficacy and safety of psychedelics for major depressive disorder. In Canada, as of 2022, psilocybin remains an experimental option that is only available through clinical trials or the special access program. As such, Canadian Network for Mood and Anxiety Treatments considers psilocybin an experimental treatment and recommends its use primarily within clinical trials, or, less commonly, through the special access program in rare, special circumstances. [ABSTRACT FROM AUTHOR]

Adaptive actions, including healthy thinking and meaningful activities, have been associated with emotional wellbeing. The Things You Do Questionnaire—21 item (TYDQ-21) has recently been created to measure the frequency of such actions. A study using the TYDQ-21 found that adaptive actions increased across Internet-delivered therapy for symptoms of depression and anxiety, and higher TYDQ-21 scores were associated with lower psychological distress at post-treatment. The current study examined the relationships between adaptive actions and psychological distress among adults (n = 1114) receiving Internet-delivered therapy as part of routine care in Canada, and explored whether adaptive actions mediated reductions in depression and anxiety. As hypothesised, adaptive actions increased alongside reductions in depression and anxiety symptoms from baseline to post-treatment. Treatment effects were consistent when the intervention was provided with regular weekly therapist support or with optional weekly therapist support, and some (but not all) types of adaptive actions had a mediating effect on change in depressive symptoms. The present findings support further work examining adaptive actions as a mechanism of change in psychotherapy, as well as the utility and scalability of Internet-delivered treatments to target and increase adaptive actions with the aim of improving mental health. [ABSTRACT FROM AUTHOR]

Background and Aims: Existing research on mental health comorbidities of youth e‐cigarette use is subject to confounding bias and reverse causality. This study aimed to measure the effects of e‐cigarette use on youth mental health, using e‐cigarette minimum legal age (MLA) law in Canada as a natural experiment. Design: We used difference‐in‐differences (DD), difference‐in‐differences‐in‐differences (DDD) and two‐sample instrumental variables (TSIV) methods. Setting: Data were from nationally representative Canadian Community Health Surveys 2008–2019 and Canadian Student Tobacco Alcohol and Drugs Surveys 2008–2019. Participants: The study sample comprised of respondents aged 15 to 18 (in DD analysis; n = 33 858) and aged 15 to 24 (in DDD analysis; n = 78 689). Measurements Primary outcomes were self‐reported mood disorders and anxiety disorders. Secondary outcomes were cannabis use, illicit drug use, cigarette use and strength of peer relationships at schools. Findings After the e‐cigarette MLA laws, risks of mood disorders declined by 1.9 percentage points (95% CI, 0.0–3.8; P = 0.05) in the DD analysis and by 2.6 percentage points (95% CI, 0.2–5.0; P = 0.03) in the DDD analysis. For anxiety disorders, while the DD estimate was negative but imprecisely estimated, the MLA law reduced risks of anxiety disorder by 3.6 percentage points (95% CI, 0.9–6.2; P = 0.01) in the DDD analysis. Youths in provinces with MLA laws were also less likely to report cannabis use and illicit drug use and more likely to feel being part of schools. TSIV analysis indicates that youth e‐cigarette use increased the likelihood of mood and anxiety disorders by 44% and 37%, respectively. Conclusion and Relevance: In Canada, the e‐cigarette minimum legal age law appears to have reduced risks of mood and anxiety disorders, lowered substance use and improved peer relationships at schools. Combined with previous evidence of lower e‐cigarette use following the minimum legal age law, our findings indicate that youth e‐cigarette use increases risks of mood and anxiety disorders. [ABSTRACT FROM AUTHOR]

We documented changes in depressive and anxiety symptoms from before to during the COVID-19 pandemic among young adults and investigated whether changes differed across participant characteristics. Data were available in an investigation of 1294 grade 7 students recruited in 1999–2000. For this analysis, we used data collected pre-pandemically in 2017–20 (mean (SD) age = 30.6 (1.0)) and during the pandemic in 2020–21 (mean (SD) age = 33.6 (0.6)). 673 participants with data in both cycles were retained for analysis. Symptoms were measured using the Major Depression Inventory (MDI) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Standardized mean differences (SMD) of changes in MDI and GAD-7 values between cycles were calculated across participant characteristics. On average, MDI scores increased by 2.1 (95%CI 1.4, 2.8) points during the pandemic from mean 10.5; GAD-7 scores increased by 1.2 (0.8, 1.5) points from mean 4.7. The SMD was 0.24 (0.14, 0.33) for MDI, and 0.24 (0.13, 0.34) for GAD-7. No differences in MDI change scores were observed across participant characteristics. Differences in GAD-7 change scores were observed by mood/anxiety disorder (SMD − 0.31 (− 0.58, − 0.05)), household income (0.24 (0.02, 48)), living with young children (− 0.56 (− 1.23,− 0.05)), and adherence to public health recommendations 0.58 (0.19, 1.03)). Increases in depressive and anxiety symptoms were observed 10–16 months into the COVID-19 pandemic among adults age 32–36. [ABSTRACT FROM AUTHOR]

Aim: COVID‐19 has had significant mental health impacts internationally and anxiety rates are estimated to have tripled during the pandemic, but the specific causes remain underexplored. This study's purpose was to investigate the associations of sociodemographic factors, COVID‐19‐related policies, and COVID‐19 case/mortality rates with levels of anxiety among Canadians during the pandemic. Methods: This study used linear regression models populated with three integrated sources of data: a repeated cross‐sectional survey (n = 7008), Oxford COVID‐19 Government Response Tracker data, and COVID‐19 case/mortality rates. Sociodemographic factors included were age, gender, race, province, income, education, rurality, household composition, and factors related to employment. Results: Local COVID‐19 case and mortality rates and stay‐at‐home orders were positively associated with anxiety symptom severity. Anxiety was most severe among those who: were female, Indigenous, or Middle Eastern; had postsecondary education; lived with others; and became unemployed or had working hours altered during the pandemic. Anxiety was less severe among: older adults; male, Caucasians, and black individuals; those with high incomes, and; those for whom employment did not change during the pandemic. Conclusion: Anxiety was primarily driven by socioeconomic factors among Canadians during the COVID‐19 pandemic. Policies that alleviate socioeconomic uncertainty for groups that are most vulnerable may reduce the long‐term harm of the pandemic and associated lockdown policies. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is well-known that psychosocial health status of paramedics may be altered by their job demands. However, it is unknown whether psychosocial health status can affect occupational performance. OBJECTIVE: The goal of this study was to explore whether a paramedic's symptom severity of Occupational Stress Injury (OSI) was related to simulated patient-care performance. METHODS: Nineteen paramedics with 15.0±8.7 years of paramedic experience participated in this study. Participants completed both an OSI symptom severity questionnaires, and a patient-care simulation. Vagal activity was also collected during the patient-care simulation. The simulation was used to assess experienced paramedics in a realistic stressful setting. Based on the provincial standard in New Brunswick, an experienced paramedic instructor graded the patient-care simulation using the provincial standard charts, observing performance videos and assessing data from the manikin. RESULTS: The current study suggests that paramedics who self-reported elevated symptoms of OSI were less likely to successfully complete the simulated patient-care scenario. CONCLUSION: This research suggests that the presence of self-reported elevated symptoms of OSI negatively impacts paramedics' performance during a stressful work task simulation. Therefore, to help paramedics maintain optimal performance, it may be important to ensure that paramedics have access to appropriate resources to monitor and improve their psychosocial health. [ABSTRACT FROM AUTHOR]

Background: This project aims to characterize the extent and nature of impostor phenomenon (IP) among women surgeons in Canada. IP is well documented among medical professionals and trainees. It is known to have significant impacts on mental health and career trajectory., Study Design: We conducted a cross-sectional survey of self-identifying women who have completed a surgical residency and currently or most recently practiced in Canada., Results: Among 387 respondents, 98.7% have experienced IP. Median IP score corresponded to frequent impostor feelings or high impostorism. Self-doubt affects most women surgeons for the first time during training. It tends to be most intense in the first 5 years of practice and lessens over time. One hundred twelve (31.5%) surgeons experience self-doubt in the operating room (OR). Due to self-doubt, 110 (28.4%) respondents preferred to work with a more experienced assistant in the OR, whereas 40 (10.4%) stated that they would only operate with an experienced assistant. Few surgeons take on less OR time due to self-doubt (29 [7.5%]), but 60 (16.5%) take on fewer complex cases due to self-doubt. A small but important number of surgeons (11 [2.8%]) had given up operating altogether due to self-doubt. Due to feelings of self-doubt, 107 (21.4%) respondents were hesitant to take on a leadership role in the workplace., Conclusions: IP is a nearly universal experience among women surgeons and is influential in their professional lives. This study contributes to scientific knowledge that can advance gender equity in medicine and leadership., (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background: Despite anxiety disorders being the ninth leading cause of disability and associated with social inequities, little attention has been given to how intersections among social determinants of health and chronic stressors such as cumulative lifetime violence affect the likelihood of experiencing anxiety disorders. Our purpose was to explore the relationships among cumulative lifetime violence severity as target and perpetrator, social determinants of health and generalized anxiety disorder in Canadian men. Methods: Using a community sample of 592 Canadian men who self-identified as having experienced violence, we developed and tested an evidence-based model of generalized anxiety disorder including indicators of cumulative lifetime violence, gender, social location, socio-economic disparity, personal resources and other chronic stressors using logistic regression. Results: Most men (76.4%, n = 452) reported experiences as both target and perpetrator. The model accounted for 50.8% of the variance in anxiety severity χ2 (8) = 264.43, p =.000). The prevalence of probable generalized anxiety disorder was 30.9%, a rate higher than that found among Canadian men in general in the same period. Remarkably, the likelihood of generalized anxiety disorder increased by a factor of 5.30 for each increase of 1 in cumulative lifetime violence severity, and six-fold for feeling overwhelmed by demands of everyday life (aOR = 6.26). Masculine discrepancy stress, having been born in Canada, unemployment, and food insecurity also contributed significantly to increasing the likelihood of generalized anxiety disorder. Both social support and mastery had significant aORs < 1, suggesting possible protective effects. Together these findings delineate characteristics and social determinants that may heighten vulnerability to generalized anxiety disorder and influence its progression among men who have experienced lifetime violence. Conclusions: These findings are the first evidence that Canadian men with lifetime violence histories are a sub-group disproportionately affected by chronic stressors and socio-economic disparities and that together the presence and/or severity of these factors increases their vulnerability to generalized anxiety disorder. Our results highlight the importance of strengths-based trauma- and violence-informed approaches to care, including practical resources to reduce the stress of everyday life, improve social support, and reinforce personal control and choice. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of comorbid chronic conditions among Canadian adults with cancer and the impact of socioeconomic background on the distribution of these conditions. Canadian Community Health Survey (CCHS) 2017–2018 dataset was accessed and individuals with complete information about cancer history were reviewed. The prevalence of the following 10 chronic conditions was reviewed: asthma, chronic obstructive pulmonary disease, arthritis, hypertension, hypercholesterolemia/hyperlipidemia, heart disease, stroke, diabetes, mood disorder, and anxiety disorder. Stratification of the prevalence was done according to age, sex, and racial subgroups. Multivariable logistic regression analysis was done to evaluate the association between sociodemographic characteristics and having multiple comorbid conditions. A total of 104,362 participants were included in the current study (including 10,782 participants with a history of cancer; and 93,580 participants without a history of cancer). Among all age, sex, and race strata, participants with a history of cancer were more likely to have multiple chronic conditions (p < 0.05 for all comparisons). The most common three individual comorbid conditions among participants with cancer were arthritis (40.2%), hypertension (36.1%), and hypercholesterolemia (25.2%); while the most common cancer-comorbidity triad among participants with cancer was cancer/arthritis/hypertension (17.7%). In a multivariable logistic regression analysis among participants with cancer, the following sociodemographic factors were associated with having multiple comorbid conditions: older age (OR for age 80+ versus age 18–20 years: 8.32; 95% CI: 5.17–13.39), indigenous racial group (OR: 1.94; 95% CI: 1.43–2.63) and lower income (OR for income ≥80,000 Canadian dollars (CAD) versus income: ≤20,000 CAD: 0.29; 95% CI: 0.23–0.37). History of cancer is associated with a higher probability of many comorbid conditions. This excess comorbidity burden seems to be unequally shouldered by individuals in the lower socioeconomic stratum as well as minority populations. [ABSTRACT FROM AUTHOR]

Background: Research has identified a link between Attention-Deficit Hyperactivity Disorder (ADHD) and Generalized Anxiety Disorder (GAD). The aims of this study were to investigate the relationship between ADHD and GAD, and to identify significant correlates of GAD among those with ADHD.Methods: Data were derived from the nationally representative 2012 Canadian Community Health Survey-Mental Health. The sample included 6,989 respondents aged 20-39, of whom 682 had GAD. Bivariate and logistic regression analyses were conducted to determine the degree to which the association between ADHD and GAD was attenuated by demographics, socioeconomic status, social support, spirituality, childhood adversities, depression, and substance abuse/dependence. Additional analyses were conducted using the subsample of those diagnosed with ADHD (n = 272) to determine factors associated with GAD.Results: 1 in 9 respondents with GAD had ADHD, in comparison to 1 in 33 of those without GAD. The age-sex-race adjusted odds of GAD were four-fold for those with ADHD in comparison to those without ADHD. After adjusting for all covariates, the odds of GAD were still more than double for those with ADHD. Factors associated with GAD among those with ADHD include being female, having an income <$40,000, having fewer close relationships, and having a lifetime history of depression.Limitations: Cross-sectional design prohibits causal inferences.Conclusion: The high co-morbidity between ADHD and GAD emphasizes the need for targeted intervention to support these often overlapping disorders. [ABSTRACT FROM AUTHOR]

Aim: The COVID‐19 quarantine closed many mental health services. Emerging adults with pre‐existing mood or anxiety disorders were of concern for worsening symptoms. We sought to demonstrate a method for monitoring mental health status of a group of patients with reduced access to their usual mental health services during quarantine. Methods: A total of 326 patients enrolled in the First‐Episode Mood and Anxiety Program in London, Ontario, Canada were invited to participate in online questionnaires regularly. Patients were flagged for high level of risk based on depression scores, suicidal ideation and worsening in anxiety, depression or quality of health. All patients were also asked if they wanted contact with a clinician. Results: One hundred and fourteen (35%) patients completed at least one questionnaire. Thirty were flagged based on scores; 37 (32.5%) participating patients requested help. Participants who were flagged for concerning scores were younger, more likely to be on the wait list for treatment, to have been laid off from work and have more functional impairment. Participants requesting support had higher symptom scores for depression and lower scores on quality of health. Conclusions: The process utilized here identified patients at risk and in need of clinical support in the context of pandemic quarantine. It provided an accessible avenue for invited patients to communicate both symptom status and need for contact. Such a process can provide valuable monitoring during times when the usual communications between patients and health care providers is compromised and clinician time is limited. It is easily implemented. [ABSTRACT FROM AUTHOR]

The etiology of pediatric abdominal disorders is poorly understood, and the relationship with maternal mental health is understudied. We sought to determine the association between maternal psychiatric disorders and abdominal conditions in childhood. We performed a retrospective cohort study of 1,080,518 newborns in Quebec, Canada, between 2006 and 2020. We identified maternal mental disorders before or during pregnancy and computed the incidence of abdominal disorders in offspring before 1 year of age. Outcomes included Hirschsprung disease; hypertrophic pyloric stenosis; and esophageal, intestinal, and biliary atresia. We calculated adjusted risk ratios (RR) with 95% confidence intervals (CI) for the association of maternal mental disorders with these pediatric abdominal disorders. Among 51,371 children exposed to maternal mental disorders, 200 children had an abdominal condition, for a rate of 38.9 cases per 10,000 children (95% CI 33.6–44.3) compared with 27.7 per 10,000 for children who were unexposed to maternal mental disorders (95% CI 26.7–28.7). Compared with no mental disorder, maternal mental disorders were associated with hypertrophic pyloric stenosis (RR 1.39, 95% CI 1.16–1.68). Associations were stronger for severe mental disorders and were more marked for depression and stress and anxiety disorders. Maternal mental disorders are associated with the risk of hypertrophic pyloric stenosis in offspring. The origin of hypertrophic pyloric stenosis may relate to maternal mental disorders that were present during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are the most common mental disorders, for which some countries and organizations have developed guidelines. It is necessary to understand the quality of these guidelines.Methods: The relevant guidelines were searched systematically by five reviewers using Appraisal of Guidelines for Research and Evaluation (AGREE) II and AGREE Recommendation Excellence (AGREE-REX) instruments. The scores in each domain were descriptively analyzed, and guidelines from different countries were compared.Results: Seventeen guidelines were included. The scores in the domains "rigor of development" and "applicability" were the lowest and ranged from 16% to 77% and 25% to 71%, respectively. The scores in the domains "implementability" and "values and preferences" were similar and ranged from 30% to 67% and 25% to 77%. In terms of the comparison among countries, the Canadian guidelines achieved the highest scores in many domains but only scored 43% in the domain of "values and preferences". The Indian guidelines scored less than 50% in many domains but achieved a high score of 83% in the domain "scope and purpose".Limitations: Language restrictions may cause selection bias. Besides, insufficient reports may lead to deviation of assessment results.Conclusions: There was no obvious advantage in guidelines from different countries. There was still a lot of room for improvement in some domains, especially "applicability", "implementability", "rigor of development" and "values and preferences". [ABSTRACT FROM AUTHOR]

Objective: The literature on transdiagnostic psychotherapy among youths is limited. Group transdiagnostic behavior therapy (TBT) has been shown to be effective for adults with affective disorders and may contain beneficial features for youths (e.g., behavioral focus, group format, ease of dissemination, and diversity of targeted diagnoses). This study aimed to investigate group TBT among youths in Canada to determine its feasibility and efficacy. Methods: Twenty participants (ages 16-19) diagnosed as having a principalanxietydisorder completed 12sessions of group TBT. Symptoms of anxiety, depression, and transdiagnostic impairment were assessed pre-and posttreatment. Results: Participants demonstrated significant improvements on measures of anxiety (general, cognitive, and somatic) and stress, with moderate effect sizes. Findings for symptoms of depression and transdiagnostic impairment were unreliable, with small effect sizes. Conclusions: These findings provide preliminary support for the use of group TBT among youths with anxiety disorders. Future research should incorporate comparison groups and larger samples. [ABSTRACT FROM AUTHOR]

Objectives: To characterize health related quality of life (HRQOL) for Canadians aged 16 to 25 (adolescents and young adults, AYAs) seeking care for mood and anxiety concerns at the First Episode Mood and Anxiety Program, in London, Ontario and to identify factors associated with HRQOL in this population., Methods: AYAs completed demographic, psychometric, and HRQOL questionnaires. We calculated 36-Item Short-Form Health Survey (SF-36) scores standardized to Canadian and US population norms. We computed Short Form 6 Dimension (SF-6D) utilities conducting multivariable linear regression analysis, adjusting for age, sex, ethnoracial minority status, parental marital/cohabitation status, parental education, the Anxiety Sensitivity Index (ASI-R), Montgomery-Åsberg Depression Rating Scale Self-Report (MADRS-S), Sheehan Disability Scale (SDS), and a modified Inventory of College Students' Recent Life Experiences (ICSRLE-M)., Results: Amongst 182 AYAs who completed questionnaires, mean physical component summary (PCS), mental component summary (MCS) and SF-6D utility scores were low, 43.8 (SD = 16.6), 19.0 (SD = 11.9) and .576 (SD = .074), respectively. Maternal post-secondary education, depression (MADRS-S) and functional impairment (SDS) were significantly associated with SF-6D utility., Conclusion: This cohort of mental healthcare-seeking AYAs had significantly impaired psychometric and utility-based measures of quality of life, underscoring the importance of timely access to healthcare services for this population., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Anxiety disorders (ADs) are associated with increased healthcare use (HCU), and individuals may seek healthcare through various pathways according to clinical and individual characteristics. This study aimed to characterize care trajectories (CTs) of individuals with ADs., Methods: This is a retrospective cohort study using the Care Trajectories - Enriched Data cohort, a linkage between the Canadian Community Health Surveys (CCHS), and health administrative data from Quebec. The cohort included 5143 respondents reporting ADs to the CCHS between 2009 and 2016. We measured CTs over 5 years before CCHS using a state sequence analysis., Results: The cohort was categorized into five types of CTs. Type 1 (52.7 %) was the lowest care-seeking group, with fewer comorbidities. Type 2 (24.0 %) had higher levels of physical and mental health comorbidities and moderate HCU, mainly ambulatory visits to general practitioners. Type 3 (13.1 %) represented older patients with the highest level of physical illnesses and high HCU, predominantly ambulatory consultation of specialists other than psychiatrists. Types 4 and 5 combined young and middle-aged patients suffering from severe psychological distress. HCU of type 4 (6.7 %) was high, mainly consultations of ambulatory psychiatrists, and HCU of type 5 (3.5 %), was the highest and mostly in acute care., Limitations: Administrative and survey data may have coding errors, missing data and self-report biases., Conclusion: Five types of CTs showed distinct patterns of HCU often modulated by physical and mental health comorbidities, which emphasizes the importance of considering ADs when individuals seek care for other mental health conditions or physical illness., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

Background: There is substantial unmet need for child and youth mental health problems in Canada. Charitable organizations, such as Kids Help Phone (KHP), are critical to filling system gaps, offering 24/7 e-mental health services outside the formal health care system. Methods: For the 5-year period from January 2018 to December 2022, we describe issues discussed by young people accessing KHP's services, and examine variations across different service platforms and age groups. Results: The most discussed issues across all service platforms and age groups were anxiety/stress, depression/sadness, and relationships. Suicide was most frequently discussed over text and Live Chat compared with other services, and was proportionally most discussed by young people 10-13 years of age on the phone and text services compared with other age ranges. Sexual abuse and violence were most frequently discussed by children 0-5 and 6-9 years of age across services. Discussion: Our analysis provides a unique snapshot into the concerns faced by children and youth across Canada, as well as the issues for which KHP is seen as an accessible place to seek support. Our findings can guide the future development of health promotion activities, and assist in new service development.

Background: Anxiety disorders are the most common psychiatric problems among Canadian youth and typically have an onset in childhood or adolescence. They are characterized by high rates of relapse and chronicity, often resulting in substantial impairment across the lifespan. Genetic factors play an important role in the vulnerability toward anxiety disorders. However, genetic contribution to anxiety in youth is not well understood and can change across developmental stages. Large-scale genetic studies of youth are needed with detailed assessments of symptoms of anxiety disorders and their major comorbidities to inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care., Methods: The Genetic Architecture of Youth Anxiety (GAYA) study is a Pan-Canadian effort of clinical and genetic experts with specific recruitment sites in Calgary, Halifax, Hamilton, Toronto, and Vancouver. Youth aged 10-19 (n = 13,000) will be recruited from both clinical and community settings and will provide saliva samples, complete online questionnaires on demographics, symptoms of mental health concerns, and behavioural inhibition, and complete neurocognitive tasks. A subset of youth will be offered access to a self-managed Internet-based cognitive behavioral therapy resource. Analyses will focus on the identification of novel genetic risk loci for anxiety disorders in youth and assess how much of the genetic risk for anxiety disorders is unique or shared across the life span., Discussion: Results will substantially inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care. Given that the GAYA study will be the biggest genomic study of anxiety disorders in youth in Canada, this project will further foster collaborations nationally and across the world., (© 2024. The Author(s).)

Background: Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these., Aims: Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place., Methods: The sample included participants ( n  = 16,435) in the five established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) who responded to the CanPath COVID-19 health surveys (May-December 2020 and January-June 2021). Multinomial regression analyses were carried out to study MHSU since the pandemic (March 2020) as a function of predisposing, enabling and need factors. Analyses were carried out in the overall sample and restricted to those with moderate and severe symptoms (MSS) of depression and/or anxiety ( n  = 2,237)., Results: In individuals with MSS of depression and/or anxiety, 14.4% reported initiating new MHSU, 22.0% had no MHSU due to barriers and personal reasons and 36.7% had no MHSU due to self-reported no need. Age, living alone, lower income, a decrease in income during the pandemic and health professional status were associated with MHSU. Younger adults were more likely to initiate MHSU during the pandemic than older adults who reported not being comfortable to seek mental health care or self-reported no need. Individuals living alone and with lower income were more likely to report not being able to find an appointment for mental health care., Conclusions: Awareness campaigns focusing on older adults that explain the importance of seeking treatment is needed, as well as sensitising health professionals as to the importance of informing and aiding individuals at risk of social isolation and lower socio-economic status as to available mental health resources and facilitating access to care., Competing Interests: Conflict of interestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.