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Objectives: Using Andersen's model of health care seeking behavior, we examined the predisposing, enabling, and need factors associated with mental health service use (MHSU) during the first wave of the COVID-19 pandemic across Canada. Methods: The sample included n = 45,542 participants in the 5 established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) and who responded to the CanPath COVID-19 health survey (May-December 2020), with complete data on MHSU. Multivariable logistic regression analyses were carried out to study MHSU as a function of predisposing, enabling, and need factors. Analyses were stratified by regional cohort. Results: Among the need factors, individuals reporting moderate/severe symptoms of depression and anxiety and poorer self-rated mental health were more likely to report MHSU. Among the enabling factors, receipt of informational/financial/practical support was associated with increased MHSU. While income was not consistently associated with MHSU, reported decrease in income was marginally associated with reduced MHSU. Among the predisposing factors, identifying as female or other gender minority was associated with increased MHSU, as was the presence of past-year cannabis use. In contrast, older age and alcohol consumption were associated with reduced MHSU. Conclusion: Need factors were consistently associated with MHSU. Although income inequities in MHSU were not observed, changes such as reduced income during the pandemic may lead to barriers in accessing mental health services. Future research should focus on better identifying contextual enabling factors and policies that overcome financial barriers to MHSU. [ABSTRACT FROM AUTHOR]

Background: Multivariable risk algorithms (MVRP) predicting the personal risk of depression will form an important component of personalized preventive interventions. However, it is unknown whether providing personalized depression risk will lead to unintended psychological harms. The objectives of this study were to evaluate the impact of providing personalized depression risk on non-specific psychological distress and functional impairment over 12 months. Methods: A mixed-methods randomized controlled trial was conducted in 358 males and 354 females who were at high risk of having a major depressive episode according to sex-specific MVRPs, and who were randomly recruited across Canada. Participants were assessed at baseline, 6 and 12 months. Results: Over 93% of participants were interested in knowing their depression risk. The intervention group had a greater reduction in K10 score over 12 months than the control group; complete-case analysis found a significant between-group difference in mean K10 change score (d = 1.17, 95% CI 0.12–2.23) at 12 months. Participants in the intervention group also reported significantly less functional impairment in the domains of home and work/school activities, than did those in the control group. A majority of the qualitative interviewees commented that personalized depression risk information does not have a negative impact on physical and mental health. Conclusions: This study found no evidence that providing personalized depression risk information will lead to worsening psychological distress, functional impairment, and absenteeism. Provision of personalized depression risk information may have positive impacts on non-specific psychological distress and functioning. Trial registration: ClinicalTrials.gov NCT02943876 [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Prevention and early detection of depression is a top public health priority. Accurate perception of depression risk may play an important role in health behavior change and prevention of depression. However, the way in which people in the community perceive their risk of developing depression is currently unknown.Methods: We analyzed the baseline data from a randomized controlled trial in 358 men and 356 women who are at high risk of having a major depressive episode (MDE). The predicted risk was assessed by sex-specific multivariable risk predictive algorithms for MDE. We compared participants' perceived risk and their predicted risk. Accurate risk perception was defined as perceived risk is in the range of predicted risk ± 10%.Results: In men, 29.7% perceived their risk accurately; 47.5% overestimated their risk; 22.8% underestimated their risk. In women, the proportions were 21.7%, 59.6% and 18.7%, respectively. Compared to men, women were more likely to overestimate their risk and less likely to be accurate. Regression modeling revealed that poor self-rated health and higher predicted depression risk were associated with inaccuracy of risk perception in men; a family history of MDE, higher psychological distress and lower predicted risk were associated with inaccuracy of risk perception in women.Conclusions: Individuals who are at high risk of developing depression tend to overestimate their risk, especially women. Inaccurate depression risk perception is related to people's health status. Educational interventions are needed to enhance the accuracy of risk perception to encourage positive behavior change and uptake of preventive strategies. [ABSTRACT FROM AUTHOR]

Objectives: The National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) was released in 2013. The objectives of this study were to 1) estimate the proportion of Canadian employers who were aware of the Standard, 2) examine the extent to which the Standard has been implemented, and 3) describe perceived barriers to implementing the Standard in Canadian organizations.Methods: A cross-sectional survey in Canadian employers was conducted between February 2015 and January 2017. A random sample of Canadian employers was selected, and the individuals who were knowledgeable about the occupational health policies of the organizations were interviewed by telephone. The participants answered questions about the awareness, implementation, perceived effects, and barriers to implementation. Descriptive statistics and chi-square tests were used to characterize the results.Results: A total of 1010 companies participated in the study. Overall, 17.0% reported that they were aware of the Standard; 1.7% and 20.3% reported that their organizations had implemented the entirety or elements of the Standard, respectively; and 71.4% of participants believed that elements of the Standard would be implemented within the next year. The perceived effects associated with implementation of the Standard included increased job satisfaction and employee retention while the greatest barrier to implementing the Standard was the belief that psychological health and safety are irrelevant in the workplace.Conclusions: Many Canadian employers are still unaware of the Standard's existence; however, most Canadian employers are positively inclined toward the Standard in its potential to help employee productivity and job satisfaction. [ABSTRACT FROM AUTHOR]

The article discusses a study which determined the persistence of same medication treatment patterns in individuals at risk of various stages of serious mental illness (SMI) through two years of the Canadian Psychiatric Risk and Outcome Study (PROCAN) follow-up. Topics include the importance of preventive treatment before the diagnosis of SMI, an overview of the PROCAN study, and the differences found between the at-risk clinical stage groups and having two years of follow-up assessments.

Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals.Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section is the first of six guidelines articles.Results: In Canada, the annual and lifetime prevalence of MDD was 4.7% and 11.3%, respectively. MDD represents the second leading cause of global disability, with high occupational and economic impact mainly attributable to indirect costs. DSM-5 criteria for depressive disorders remain relatively unchanged, but other clinical dimensions (sleep, cognition, physical symptoms) may have implications for depression management. e-Mental health is increasingly used to support clinical and self-management of MDD. In the 2-phase (acute and maintenance) treatment model, specific goals address symptom remission, functional recovery, improved quality of life, and prevention of recurrence.Conclusions: The burden attributed to MDD remains high, whether from individual distress, functional and relationship impairment, reduced quality of life, or societal economic cost. Applying core principles of care, including comprehensive assessment, therapeutic alliance, support of self-management, evidence-informed treatment, and measurement-based care, will optimize clinical, quality of life, and functional outcomes in MDD. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to estimate and compare the lifetime and 12-month prevalence of mood disorders, anxiety disorders, and substance dependence in white, Chinese, and other Asian populations in Canada and to identify correlates of mental disorders in these ethnic groups.Methods: We used data from the Canadian Community Health Survey: Mental Health and Well-Being. The WHO's Composite International Diagnostic Interview was used to assess mental disorders diagnosed according to the DSM-IV criteria. We included subjects who were white (n = 33399), Chinese (n = 733), or from other Asian populations (n = 1113). The lifetime and 12-month prevalence of mental disorders was estimated according to ethnic group.Results: The lifetime and 12-month prevalence of mental disorders in Chinese participants was lower than the prevalence rates in white participants. Other Asian participants were less likely than white individuals to have had any mood and anxiety disorder in their lifetime. The 12-month prevalence of any mental disorder in Chinese participants was lower than in other Asian participants. However, the proportion of Chinese participants with perceived fair to poor mental health was higher than in the other Asian and white groups.Conclusions: The prevalence of mental disorders among Chinese individuals living in Canada resembles that in China's population. The prevalence of mental disorders in the Asian populations may vary by region. Studies are needed to examine subthreshold mental disorders in the Asian populations as well as ethnic differences in mental disorders in relation to sex, age, and clinical condition. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE To evaluate the association between recurrent subthreshold depressive episodes and functioning in a prospective community sample of people with type 2 diabetes. RESEARCH DESIGN AND METHODS A prospective community study in Quebec, Canada, was carried out between 2008 and 2013 (n = 1,064). Five yearly follow-up assessments (telephone interviews) were conducted. Baseline and the first three follow-up assessments were used to identify recurrent subthreshold depressive episodes (Patient Health Questionnaire [PHQ]-9). Functioning (World Health Organization Disability Assessment Schedule II [WHODAS-II]) and health-related quality of life (Centers for Disease Control and Prevention [CDC] unhealthy days) at 4- and 5-year follow-up assessments were the outcome measures. RESULTS Nearly half of the participants suffered from at least one episode of subthreshold depressive symptoms. After adjusting for potentially confounding factors, the risk of poor functioning/impaired health-related quality of life was nearly three times higher (relative risk = 2.86) for participants with four subthreshold depressive episodes compared with participants with no/minimal depression. Results suggest a dose-response relationship: the risk of poor functioning/impaired health-related quality of life increased with the number of recurrent subthreshold depressive episodes even after controlling for potentially confounding variables (significant linear trend, P < 0.001). CONCLUSIONS Recurrent subthreshold depressive symptoms might be an important risk factor for poor health outcomes in type 2 diabetes. Early identification, monitoring, and treatment of recurrent subthreshold depressive symptoms might improve functioning and quality of life in people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether job strain interacts with psychosocial factors outside of the workplace in relation to the risk of major depression and to examine the roles of psychosocial factors outside of the workplace in the relationship between job strain and the risk of major depression. Methods: Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used. Major depressive episode (MDE) in the past 12 months was assessed by the Composite International Diagnostic Interview-Short Form. Participants who were working and who were between the ages of 18 and 64 years old in 2000/2001 ( n = 6,008) were followed to 2006/2007. MDE that occurred from 1994/1995 to 2000/2001 were excluded from the analysis. Results: High job strain, negative life events, chronic stress and childhood traumatic events were associated with the increased risk of MDE. There was no evidence that job strain interacted with psychosocial factors outside of the workplace in relation to the risk of MDE. The incidence proportion in participants who reported having exposed to none of the stressors, one type of stressor, two types of stressors and three or more types of stressors was 2.6, 4.3, 6.6 and 14.2%, respectively. The odds of developing MDE in participants who were exposed to three or four types of stressors was more than four times higher than the reference group. Conclusion: MDE may be facilitated by simultaneous exposure to various stressors. There is a dose-response relationship between the risk of MDE and the number of stressors. [ABSTRACT FROM AUTHOR]

The article presents a study that assesses the correlation between workplace psychosocial factors, depression, work/family conflicts and health-related presenteeism and quality of work of employees in Canada. Researchers studied 4032 workers aged 25 to 64 years and found that 47.3% of them reported impaired job performance attributed to job strain, depression and effort-reward imbalance. They suggest that companies should impose health promotion activities to improve workers' productivity.

Abstract: Objectives: To estimate the cumulative incidence of major depressive episode (MDE) over 6 years and the associations between demographic and socioeconomic variables and MDE in a sample of the Canadian national population. Methods: Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used. MDE was assessed using the Composite International Diagnostic Interview — Short Form for Major Depression. Participants of the 2000/01 NPHS were followed until 2006/07. Individuals with previous MDE were excluded from the analysis. Proportional hazard models were developed to assess the associations between demographic, socioeconomic characteristics and MDE. Results: The cumulative incidence of MDE at 2002/03, 2004/05 and 2006/07 was 2.9% (95% confidence interval: 2.3%, 3.4%), 5.7% (95% confidence interval: 4.9%, 6.4%) and 7.2% (95% confidence interval: 6.4%, 8.1%). Women, youth, participants with one or more chronic medical conditions and those who reported family history of MDE were more likely to have developed MDE. Family history was the strongest risk factor for MDE (hazard ratio=2.01, 95% confidence interval: 1.51, 2.68). Conclusion: It may be valuable for primary and secondary prevention efforts to target women and young people. Family history is an important factor which should be considered in epidemiological studies about major depression, and also can assist in identifying those at high risk of new-onset MDE. [Copyright &y& Elsevier]

The measurement of harm in the context of non-problem gambling has received little attention from researchers in the field. Using the combined data from six provincial gambling surveys conducted in Canada between 2001 and 2005 (N = 12,285), we compared how different thresholds of defining gambling-related harm impacts prevalence, the relationship with indicators of gambling intensity and the characteristics of non-pathological gamblers who report experiencing below threshold symptoms of problem gambling. Survey items defining harm were drawn from the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index. Three definitions of harm - reporting one or more problem gambling symptoms, reporting two or more problem gambling symptoms and having a PGSI score ≥ 3 - demonstrated a strong relationship with indicators of gambling intensity, and reliably differentiated low-threshold and zero symptom problem gamblers in terms of gambling characteristics and other risk factors. [ABSTRACT FROM AUTHOR]

Health services in Canada are publicly funded. However, the use of health services, especially mental health services, by ethnic minority groups in Canada, has not been well studied. The objectives of the study were to estimate the 12-month prevalence of mental health service use by ethnicities, overall and among those with major depression, and to identify factors associated with mental health services use in different ethnic groups in Canada. Data from the Canadian Community Health Survey (CCHS-1.1) were used. Participants included in this analysis were white who were born in Canada ( n = 108,192), white immigrants ( n = 10,892), Chinese ( n = 1,785), South Asian ( n = 1,214), and South East Asian immigrants ( n = 818). Participants were selected using multiple staged, stratified random sampling procedures from household residents aged 12 years or older in ten provinces. White people were more likely to have used mental health services than Chinese participants and those from South Asian and South East Asian regions. The Chinese participants appeared to be less likely to have used mental health services than those in the South Asian and South East Asian groups, in those without major depression. In Canada, Asian immigrants are less likely to use mental health service use than white people. More studies are needed to examine factors affecting mental health service use in Asian immigrants living in North America. [ABSTRACT FROM AUTHOR]

Aims To examine the relationship between gambling behaviours and risk of gambling-related harm in a nationally representative population sample. Design Risk curves of gambling frequency and expenditure (total amount and percentage of income) were plotted against harm from gambling. Setting Data derived from 19 012 individuals participating in the Canadian Community Health Survey—Mental Health and Well-being cycle, a comprehensive interview-based survey conducted by Statistics Canada in 2002. Measurement Gambling behaviours and related harms were assessed with the Canadian Problem Gambling Index. Findings Risk curves indicated the chances of experiencing gambling-related harm increased steadily the more often one gambles and the more money one invests in gambling. Receiver operating characteristic analysis identified the optimal limits for low-risk participation as gambling no more than two to three times per month, spending no more than $501–1000CAN per year on gambling and investing no more than 1% of gross family income on gambling activities. Logistic regression modelling confirmed a significant increase in the risk of gambling-related harm (odds ratios ranging from 2.0 to 7.7) when these limits were exceeded. Conclusions Risk curves are a promising methodology for examining the relationship between gambling participation and risk of harm. The development of low-risk gambling limits based on risk curve analysis appears to be feasible. [ABSTRACT FROM AUTHOR]

Background: Although racial and ethnic disparities in health services utilization and outcomes have been extensively studied in several countries, this issue has received little attention in Canada. We therefore analyzed data from the 2001 Canadian Community Health Survey to compare the use of health services by members of visible minority groups and nonmembers (white people) in Canada. Methods: Logistic regression was used to compare physician contacts and hospital admissions during the 12 months before the survey and recent cancer screening tests. Explanatory variables recorded from the survey included visible minority status, sociodemographic factors and health measures. Results: Respondents included 7057 members of visible minorities and 114 255 white people for analysis. After adjustments for sociodemographic and health characteristics, we found that minority members were more likely than white people to have had contact with a general practitioner (adjusted odds ratio [OR] 1.28, 95% confidence interval [CI] 1.14-1.42), but not specialist physicians (OR 1.01, 95% CI 0.93-1.10). Members of visible minorities were less likely to have been admitted to hospital (OR 0.83, 95% CI 0.70-0.98), tested for prostate-specific antigen (OR 0.64, 95% CI 0.52-0.79), administered a mammogram (OR 0.68, 95% CI 0.59-0.80) or given a Pap test (OR 0.47, 95% CI 0.39-0.56). Interpretation: Use of health services in Canada varies considerably by ethnicity according to type of service. Although there is no evidence that members of visible minorities use general physician and specialist services less often than white people, their utilization of hospital and cancer screening services is significantly less. [ABSTRACT FROM AUTHOR]

Background. Major depression is a prevalent mental disorder in the general population, with a multi-factorial etiology. However, work stress as a risk factor for major depression has not been well studied.Method. Using a longitudinal study design, this analysis investigated the association between the levels of work stress and major depressive episode(s) in the Canadian working population, aged 18 to 64 years. Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used (n=6663). The NPHS participants who did not have major depressive episodes (MDE) at baseline (1994–1995 NPHS) were classified into four groups by the quartile values of the baseline work stress scores. The proportion of MDE of each group was calculated using the 1996–1997 NPHS data.Results. The first three quartile groups had a similar risk of MDE. Those who had a work stress score above the 75th percentile had an elevated risk of MDE (7·1%). Using the 75th percentile as a cut-off, work stress was significantly associated with the risk of MDE in multivariate analysis (odds ratio=2·35, 95% confidence interval 1·54–3·77). Other factors associated with MDE in multivariate analysis included educational level, number of chronic medical illnesses and child and adulthood traumatic events. There was no evidence of effect modification between work stress and selected sociodemographic, clinical and psychosocial variables.Conclusions. Work stress is an independent risk factor for the development of MDE in the working population. Strategies to improve working environment are needed to keep workers mentally healthy and productive. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the moderating effects of various coping strategies on the association between stressors and the prevalence of major depression in the general population. Methods: Subjects from the Alberta buy-in component of the 1994–1995 National Population Health Survey (NPHS) were included in the analysis (n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. The impacts of coping strategies in relation to psychological stressors on the prevalence of major depression were determined by examining interactions between coping and life stress on major depression using logistic regression modelling. Results: No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of “pray and seek religious help” and “talks to others about the situations” as coping strategies by women moderated the risk of major depression in the presence of financial stress and relationship stress (with a partner). Using emotional expression as a coping strategy by women might decrease the risk of major depression in the presence of 1 or more recent life events, personal stress, relationship stress (with a partner), and environmental stress. Conclusion: Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders. [ABSTRACT FROM AUTHOR]

Objective: To describe the use of alternative medicine (AM) by persons with major depression and to examine the factors associated with AM use among these individuals.Methods: We used data from the 1994-1995 and 1996-1997 National Population Health Surveys. We selected subjects who had major depression according to the Composite International Diagnostic Interview Short Form for Major Depression (CIDI-SFMD). The prevalence of AM and conventional health service use by the subjects was calculated for each survey and was stratified by province. We employed logistic regression to examine the factors associated with AM use.Results: There was a temporal trend toward increasing use of AM among persons with major depression. The prevalence of AM use among subjects with major depression was 7.8% in 1994-1995 and 12.9% in 1996-1997. Female sex, having more than 12 years' education, and having 1 or more long-term medical conditions were associated with an increased likelihood of using AM. The sex difference in AM use depended on subjects' age in 1996-1997.Conclusion: General practitioners, mental health specialists, and AM providers should be aware of their patients' use of both conventional medical services and AM because there may be interactions between conventional and alternative treatments. Communication and, if possible, cooperation may lead to improved outcomes in the management of depressive disorders. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of major depression on alcohol use in the Canadian general population.Method: This study was based on a 2-year follow-up of the Canadian National Population Health Survey (NPHS) longitudinal cohort. Subjects reporting various patterns of drinking, with and without major depression, were selected using the 1994-95 NPHS data. Data collected during a reevaluation of these subjects 2 years later were analyzed to determine whether having major depression at the 1994-95 interview predicted subsequent changes in drinking patterns.Results: Subjects who were depressed in 1994-95 were generally not at higher risk of starting drinking or drinking more frequently than once a week. However, women who were depressed, especially those who were 19 years old or older, were at higher risk of having 5 or more drinks at least once monthly.Conclusion: These results confirm that mood disorders can impact on alcohol consumption in women. A component of the well-known association between alcohol consumption and major depression is due to "reverse" causal effects. Proper management of depression in women may contribute to the prevention of problem drinking. [ABSTRACT FROM AUTHOR]

Background: Major depression is a prevalent mental disorder and imposes considerable burden on health and productivity. Men are not immune to major depression, yet they often delay seeking help because of perceived stigma and gender norms. E-mental health programs hold potential for early prevention of major depression. However, we have little knowledge about men's preferences for design features of e-mental health programs.Objectives: The objective of this study was to (1) estimate and compare the proportions of Internet use for medical information, preferred design features, and likely use of e-mental health programs; (2) examine factors associated with the likely use of e-mental health programs; and (3) understand potential barriers to the use of e-mental health programs among Canadian working men, who were at high risk of a major depressive episode (MDE).Methods: A cross-sectional survey in 10 Canadian provinces was conducted between March and December 2015. Random digit dialing method was used through household landlines and cell phones to collect data from 511 working men who were at high risk of having an MDE and 330 working men who were at low risk of having an MDE.Results: High-risk men were more likely to endorse the importance of accessing health resources on the Internet than low-risk men (83.4% vs 75.0%, respectively; P=.01). Of the 17 different features assessed, the top three features most likely to be used by high-risk men were: "information about improving sleep hygiene" (61.3%), "practice and exercise to help reduce symptoms of stress and depression" (59.5%), and "having access to quality information and resources about work stress issues" (57.8%). Compared with men at low risk for MDE, men at high risk for MDE were much more likely to consider using almost every one of the different design features. Differences in preferences for the design features by age among men at high risk of MDE were found only for 3 of 17 features. Differences in preferences for design features between English- and French-speaking participants were found only for 4 out of the 17 features. Analysis of qualitative data revealed that privacy issues, perceived stigma, ease of navigation, personal relevance, and lack of personal interaction, time, and knowledge were identified as barriers to the use of e-mental health programs in working men who were at high risk of MDE.Conclusion: E-mental health programs may be a promising strategy for prevention of depression in working men. Development of e-mental health programs should consider men's preferences and perceived barriers to enhance the acceptability of this approach. [ABSTRACT FROM AUTHOR]

Global health has stimulated a lot of students and has attracted the interest of many faculties, thereby initiating the establishment of many academic programs on global health research and education. global health education reflects the increasing attention toward social accountability in medical education. This study aims to identify gaps in the studies on global health education. A critical literature review of empirical studies was conducted using Boolean search techniques. A total of 238 articles, including 16 reviews, were identified. There had been a boom in the numbers of studies on global health education since 2010. Four gaps were summarized. First, 94.6% of all studies on global health education were conducted in North American and European countries, of which 65.6% were carried out in the United States, followed by Canada (14.3%) and the United Kingdom (9.2%). Only seven studies (2.9%) were conducted in Asian countries, five (2.1%) in Oceania, and two (0.8%) in South American/Caribbean countries. A total of 154 studies (64.4%) were qualitative studies and 64 studies (26.8%) were quantitative studies. Second, elective courses and training or programs were the most frequently used approach for global health education. Third, there was a gap in the standardization of global health education. Finally, it was mainly targeted at medical students, residents, and doctors. It had not granted the demands for global health education of all students majoring in medicine-related studies. Global health education would be a potentially influential tool for achieving health equity, reducing health disparities, and also for future professional careers. It is the time to build and expand education in global health, especially among developing countries. Global health education should be integrated into primary medical education. Interdisciplinary approaches and interprofessional collaboration were recommended. Collaboration and support from developed countries in global health education should be advocated to narrow the gap and to create further mutual benefits. [ABSTRACT FROM AUTHOR]

Major depression is a prevalent mental disorder in the working population. Improving the work environment may reduce the risk of major depression. The authors examined data from the longitudinal cohort of the Canadian National Population Health Survey from 1994–1995 to 2004–2005. Survey participants were classified into 4 groups by changes in job strain status from 1994–1995 to 2000–2001 (no change in low job strain, no change in high job strain, changing from high to low job strain, and changing from low to high job strain). The incidence proportion of major depressive episodes in each of the 4 groups was 4.0%, 8.0%, 4.4%, and 6.9%, respectively. Participants who reported a change from high to low job strain had a risk of major depression similar to those exposed to persistently low job strain. Among those exposed to persistent high job strain, only participants who reported good or excellent health at baseline had a higher risk of major depression, but those who reported fair or poor health did not. Reducing job strain may have positive impacts on the risk of depression. Self-rated health is a strong predictor of depression and plays an important role in the relation between job strain and depression. [ABSTRACT FROM AUTHOR]

Background: Increasing provision of treatment should theoretically lead to a decreased burden of major depressive episodes (MDE) in the population. However, there is no evidence yet that this has occurred. Among possible explanations are that: (1) treatment may not be sufficiently accessible, effective or effectively delivered to make a difference at the population level or (2) treatment benefits such as diminished episode duration may be offset by other trends such as increasing episode incidence, or vice versa.Methods: MDE prevalence has been assessed in a series of national surveys and in a single national longitudinal study in Canada. These studies included a short form version of the Composite International Diagnostic Interview module for major depression. Indicators of incidence and episode duration of MDE were estimated. Meta-regression methods were used to examine trends over time.Results: No evidence of increasing incidence nor of diminishing duration of MDE was found. The analysis failed to uncover evidence that the epidemiology of this condition has been changing.Limitations: Most studies included in this analysis used an abbreviated interview for MDE which may lack sensitivity and/or specificity. These studies could not address potential benefits of treatment on prevention of suicide. Some potentially offsetting effects could not be assessed, e.g. economic or societal changes.Conclusion: These results suggest that more effective efforts to prevent MDE, or to improve the volume or quality of treatment, are necessary to reduced burden of MDE in the population. [ABSTRACT FROM AUTHOR]

The estimated societal and economic costs of mental illness and psychological injury in the workplace is staggering. Governments, employers and other stakeholders have been searching for policy solutions. This qualitative, exploratory study sought to uncover organizational receptivity to a voluntary comprehensive standard for dealing with psychological health and safety in the workplace. A series of five focus groups were conducted in a large Western Canadian city in November 2013. The seventeen participants were from the fields of healthcare, construction/utilities, manufacturing industries, business services, and finance. They worked in positions of management, consulting, human resources, health promotion, health and safety, mediation, and occupational health and represented organizations ranging in size from 20 to 100,000 employees. The findings confirm and illustrate the critical role that psychological health and safety plays across workplaces and occupations. This standard resonated across the represented organizations and fit with their values. This alignment posed challenges with articulating its added value. There appears to be a need for simplified engagement and implementation strategies of the standard that can be tailored to the nuanced differences between types and sizes of industries. It appears that organizations in the most need of improving psychological health and safety may be the least receptive. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of the present study was to identify and describe longitudinal patterns of depression in a community sample of people with type 2 diabetes in Quebec, Canada. Methods: A prospective community based study in Quebec, Canada, was carried out between 2008 and 2011. Participants with diabetes were assessed at baseline and at 1, 2 and 3years follow-up (n=1388). Depression was assessed using the Patient Health Questionnaire (PHQ-9). Results: Longitudinal latent class analysis yielded four clusters representing different longitudinal patterns of depression: Cluster 1 (“no depression”; 67%): participants had neither minor nor major depression over time. Cluster 2 (“slowly increasing prevalence of minor and major depression over time”; 20%): participants had low levels of depression at baseline but increasing levels of minor and major depression over time; while most of the Cluster 3 (“increasing major depression”; 6%) participants had high and increasing levels of major depression over time. Participants in Cluster 4 (“improved depression”; 7%) started with high levels of depression but progressed to low levels of depression. Conclusions: Our results provide important evidence of different longitudinal patterns of depression in people with type 2 diabetes. Identification of four distinct groups of participants might improve our understanding of the course of depression and may provide a basis of classification for intervention. [Copyright &y& Elsevier]