[A framework to support action in population mental health]. / Un cadre de référence pour soutenir l'action en santé mentale des populations.

In Quebec, like elsewhere in the world, we are witnessing a growing concern for the population's mental health and for the importance of concentrating efforts on prevention and promotion. In this context, public health actors are invited to adopt a leadership role in advancing mental health promotion and mental disorder prevention goals, and establish the required partnerships with actors from the health and social services and from other sectors who are indispensable to the population mental health agenda. In Canada, public heath actors are not yet sufficiently supported in this role. They express the need to access structuring frameworks which can clarify their action in mental health. This article first presents the momentum for change at the policy level within the field of mental health. A framework to support population mental health action is then presented. The framework identifies the various dimensions underlying the promotion of population mental health as well as the reduction of mental health inequalities. The article finally illustrates how the application of a populational (the application of a populational responsibility perspective) responsibility perspective, as it is defined in the context of Quebec, facilitates the implementation of the various elements of this framework. In the end, public health actors are better equipped to situate their practice in favour of the population's mental health.

Identifying cognitive problems in children and adolescents with depression using computerized neuropsychological testing.

Depression in children and adolescents can negatively impact cognitive functioning, social development, and academic performance. The purpose of this study was to determine whether a computerized battery of neuropsychological tests could detect neurocognitive difficulties in children and adolescents with depression. Participants included 30 children and adolescents between the ages of 9 and 17 years (M = 14.6, SD = 2.1) with a clinical diagnosis of depression. Healthy control participants were individually matched on age, education, sex, race, primary language, handedness, and self-reported computer familiarity. All participants completed the Central Nervous System Vital Signs computerized battery. This battery of seven tests yields 23 test scores and 5 domain scores (Memory, Psychomotor Speed, Reaction Time, Complex Attention, and Cognitive Flexibility). Children and adolescents with depression performed worse on the Memory (Cohen's d = .43) and Complex Attention domains (d = .58) than matched controls. On the individual test scores, children and adolescents with depression performed worse on delayed verbal memory (d = .63), delayed visual memory (d = .34), measures of reaction time (d = .34-.53), and accuracy/inhibition on complex attention tasks (d = .49-.65). When considering the five domain scores simultaneously, children and adolescents with depression were more likely to have two or more scores at or below the 5th percentile (p = .05). Children and adolescents with depression have problems with reduced processing speed, memory for verbal information, and executive functioning on this computerized battery of tests, which represents a feasible method for neuropsychological screening.

Dietary PUFA supplements reduce memory deficits but not CA1 ischemic injury in rats.

The purpose of the present study was to examine the impact of nutritional supplementation with essential omega 3 and 6 fatty acids on CA1 neuronal death and recovery of functional impairments following global ischemia. Groups of Wistar male rats were randomly assigned to four experimental conditions determined by the consumed diet and surgical condition. Rats either received a standard diet (SD; Purina 5012) or a 15% PUFA supplemented diet (FO+CO) prepared by adding 11.5% (w/w) fish oil from menhaden fish and 3.5% corn oil to standard rat chow. Diet conditions were initiated in 30 day old rats and maintained for an 18-week period (pre- and post-surgery). Sham or 8-min global ischemic surgeries occurred during the 13th feeding week and behavioral testing took place following reperfusion for an additional 4 weeks, after which all rats were euthanized. Our findings revealed significant loss of pyramidal CA1 neurons 31 days post ischemia in ischemic as compared to sham-operated rats but no difference between ischemic animals fed the SD or PUFA supplemented diets. In the radial arm maze, SD ischemic rats took longer time to complete the task and made significantly more working memory errors than PUFA ischemic and sham-operated animals. Independent of the diet, ischemic animals appeared less anxious in the elevated plus maze, spending considerably more time in the open arms as compared to sham-operated rats. Taken together, these results suggest that fish oil supplemented diet exerts beneficial effect on ischemia-induced spatial memory deficits despite protective effects on CA1 hippocampal neurons.

Food restriction attenuates ischemia-induced spatial learning and memory deficits despite extensive CA1 ischemic injury.

The purpose of the present study was to examine whether short-term food restriction (40% less food over a 3-month period) can attenuate ischemia-induced CA1 neuronal degeneration, and whether this attenuation translated into improved recovery of functional impairments following global ischemia. There was a significant loss of pyramidal CA1 neurons in ischemic compared to sham-operated rats but no difference between the ad lib and food-restricted ischemic animals. Although the diet did not influence neuronal damage in ischemic animals, the performance of food-restricted ischemic rats in spatial task such as the radial arm maze was significantly better than that of ad lib fed ischemic rats. Food-restricted ischemic rats made equivalent numbers of working memory errors as sham-operated animals and took the same time to complete a standard 8-arm radial arm maze task. They also displayed higher activity level in the open field compared to ad libitum fed ischemic rats, and spent considerably more time in the open arms of the elevated plus maze compared to the other groups, suggesting decreased anxiety in these ischemic rats. The relative sparing of spatial memory performance in food-restricted ischemic animals suggests that food restriction facilitates functional recovery.

Standardization of quantitative tests for preclinical detection of neuromotor dysfunctions in pediatric neurotoxicology.

In the neurotoxicology pediatric domain, few neuromotor tests are specifically designed to be sensitive enough for the early detection of subtle deficits in voluntary and involuntary movements. In research and clinical domains, an effort is done to objectify or quantify the qualitative aspects of a movement (pattern of movement) in predicting neurological problems. This study aimed to standardize quantitative motor measures initially developed for adults and adapted to the evaluation of preschoolers. The sample consisted of 110 healthy children aged 4-6. The following quantitative neuromotor tests were selected: alternating movements and pointing movements (DOCO Microsystèmes Inc., Montréal, Canada), postural tremor, postural sway and simple reaction time (Danish Product Development Ltd., Snekkersten, Denmark). Validation measures included global motor tasks and a neurological examination. Results indicate adequate test-retest reliability and complementarities amongst the selected voluntary and involuntary measures. Both the feasibility and relevance of quantitative neuromotor tests in preschool aged children were established. Results also provide a representation of intra-individual and inter-individual variability within this population. Lastly, the results highlight the importance of developmental factors, behavioral factors and testing conditions in the neuromotor evaluation of young children. The proposed tests could help in the early detection of children at risk for motor dysfunctions following neurotoxic exposure. The tests can also be used for the follow up of various conditions relating to motor functions (cerebral palsy, muscular dystrophy, preterm infants) and in the evaluation of the effects of medication.