Childhood maltreatment and major depressive disorder in well-being: a network analysis of a longitudinal community-based cohort.

BACKGROUND: Little has been done to comprehensively study the relationships between multiple well-being constructs at a time. Even less is known about whether child maltreatment and major depressive disorder (MDD) impact different well-being constructs. This study aims to examine whether maltreated or depressed individuals have specific impacts on well-being structures. METHODS: Data analyzed were from the Montreal South-West Longitudinal Catchment Area Study (N = 1380). The potential confounding of age and sex was controlled by propensity score matching. We used network analysis to assess the impact of maltreatment and MDD on well-being. The centrality of nodes was estimated with the 'strength' index and a case-dropping bootstrap procedure was used to test network stability. Differences in the structure and connectivity of networks between different studied groups were also examined. RESULTS: Autonomy and daily life and social relations were the most central nodes for the MDD and maltreated groups [MDD group: strength coefficient (SC) autonomy = 1.50; SCdaily life and social relations = 1.34; maltreated group: SCautonomy = 1.69; SCdaily life and social relations = 1.55]. Both maltreatment and MDD groups had statistical differences in terms of the global strength of interconnectivity in their networks. Network invariance differed between with and without MDD groups indicating different structures of their networks. The non-maltreatment and MDD group had the highest level of overall connectivity. CONCLUSIONS: We discovered distinct connectivity patterns of well-being outcomes in maltreatment and MDD groups. The identified core constructs could serve as potential targets to maximize the effectiveness of clinical management of MDD and also advance prevention to minimize the sequelae of maltreatment.

Psychological interventions for loneliness and social isolation among older adults during medical pandemics: a systematic review and meta-analysis.

OBJECTIVES: There is little research conducted to systematically synthesize the evidence on psychological interventions for social isolation and loneliness among older adults during medical pandemics. This systematic review aims to address this information gap and provides guidance for planning and implementing interventions to prevent and reduce loneliness and social isolation for older adults, especially during medical pandemics. METHODS: Four electronic databases (EMBASE, PsychoInfo, Medline and Web of Science) and grey literature from 1 January 2000 to 13 September 2022 were searched for eligible studies on loneliness and social isolation. Data extraction and methodological quality assessment on key study characteristics were conducted independently by two researchers. Both qualitative synthesis and meta-analysis were used. RESULTS: The initial search yielded 3,116 titles. Of the 215 full texts reviewed, 12 intervention articles targeting loneliness during the COVID-19 pandemic met the inclusion criteria. No studies were found concerning intervention with respect to social isolation. Overall, interventions targeting social skills and the elimination of negativities effectively alleviated the feelings of loneliness in the older population. However, they had only short-term effects. CONCLUSION: This review systematically summarised the key characteristics and the effectiveness of existing interventions addressing loneliness in older adults during the COVID-19 pandemic. Future interventions should focus on social skills and eliminating negativities and be tailored to the needs and characteristics of older people. Repeated larger-scale randomized controlled trials and long-term effectiveness evaluations on this topic are warranted.

Prevalence of loneliness and social isolation among older adults during the COVID-19 pandemic: A systematic review and meta-analysis.

OBJECTIVES: Pandemics and their public health control measures have generally substantially increased the level of loneliness and social isolation in the general population. Because of the circumstances of aging, older adults are more likely to experience social isolation and loneliness during pandemics. However, no systematic review has been conducted or published on the prevalence of loneliness and/or social isolation among the older population. This systematic review and meta-analysis aims to provide up-to-date pooled estimates of the prevalence of social isolation and loneliness among older adults during the COVID-19 pandemic and other pandemics in the last two decades. DESIGN: EMBASE, PsychoINFO, Medline, and Web of Science were searched for relevant studies from January 1, 2000 to November 31, 2021 published in a variety of languages. Only studies conducted during the COVID-19 pandemic were selected in the review. RESULTS: A total of 30 studies including 28,050 participants met the inclusion criteria. Overall, the pooled period prevalence of loneliness among older adults was 28.6% (95% CI: 22.9-35.0%) and 31.2% for social isolation (95% CI: 20.2-44.9%). Prevalence estimates were significantly higher for those studies conducted post 3-month from the start of the COVID-19 pandemic compared to those conducted within the first 3 months of the pandemic. CONCLUSIONS: This review identifies the need for good quality longitudinal studies to examine the long-term impact of pandemics on loneliness and social isolation among older populations. Health policymaking and healthcare systems should proactively address the rising demand for appropriate psychological services among older adults.

The relationship between childhood maltreatment and mental health problems: coping strategies and social support act as mediators.

BACKGROUND: Childhood maltreatment significantly increases the risk of developing mental health problems in adolescence and adulthood. The present study examines if coping strategies and social support mediate the relationship between childhood maltreatment and mental health problems. METHODS: Data analyzed were from the 2012 Canadian Community Health Survey Mental Health (CCHS-MH, N = 25,113), a national population survey. A structured diagnostic interview, the World Health Organization version of Composite International Diagnostic Interview (WHO-CIDI), was used to assess mental health status. Multiple mediation analysis with structural equation modelling is used to test the mediating effects of coping skills and social support in the relationship between childhood maltreatment and mental health problems. RESULTS: Our findings demonstrate that both coping strategies and social support mediated the link between childhood maltreatment and major depressive episode (mediation proportion: 18.3%), generalized anxiety disorder (mediation proportion: 19.8%), and suicide ideation (mediation proportion: 15.9%). By and large, the study results showed that coping skills and social support had both direct and indirect effects on the studied mental health problems with coping skills having a stronger impact. CONCLUSIONS: Personal resources play an important resilience role in the associations between maltreatment and mental disorders with positive coping strategies, an internal resource, having a stronger protective presence. This research reinforces the need for strengthening positive coping strategies as well as social support as preventive strategies to improve mental health for individuals who have experienced childhood maltreatment.

To what extent do social support and coping strategies mediate the relation between childhood maltreatment and major depressive disorder: A longitudinal community-based cohort.

This study aimed to articulate the roles of social support and coping strategies in the relation between childhood maltreatment (CM) and subsequent major depressive disorder (MDD) with a comprehensive exploration of potential factors in a longitudinal community-based cohort. Parallel and serial mediation analyses were applied to estimate the direct effect (DE) (from CM to MDD) and indirect effects (from CM to MDD through social support and coping strategies, simultaneously and sequentially). Sociodemographic characteristics and genetic predispositions of MDD were considered in the modeling process. A total of 902 participants were included in the analyses. CM was significantly associated with MDD (DE coefficient (ß) = 0.015, 95% confidence interval (CI) = 0.002∼0.028). This relation was partially mediated by social support (indirect ß = 0.004, 95% CI = 0.0001∼0.008) and negative coping (indirect ß = 0.013, 95% CI = 0.008∼0.020), respectively. Social support, positive coping, and negative coping also influenced each other and collectively mediated the association between CM and MDD. This study provides robust evidence that although CM has a detrimental effect on later-on MDD, social support and coping strategies could be viable solutions to minimize the risk of MDD. Intervention and prevention programs should primarily focus on weakening negative coping strategies, then strengthening social support and positive coping strategies.

Unmet health care needs: factors predicting satisfaction with health care services among community-dwelling Canadians living with neurological conditions.

BACKGROUND: Neurological conditions (NCs) can lead to long-term challenges including functional impairments and limitations to activities of daily living. People with neurological conditions often report unmet health care needs and experience barriers to care. This study aimed to (1) explore the factors predicting patient satisfaction with general health care, hospital, and physician services among Canadians with NCs, (2) examine the association between unmet health care needs and satisfaction with health care services among neurological patients in Canada, and (3) contrast patient satisfaction between physician care and hospital care among Canadians with NCs. METHODS: We conducted a secondary analysis on a subsample of the 2010 Canadian Community Health Survey - Annual Component data (N = 6335) of respondents with neurological conditions, who received general health care services, hospital services, and physician services within twelve months. Multivariate logistic regression fitted the models and odds ratios and 95% confidence intervals were reported using STATA version 14. RESULTS: Excellent quality care predicts higher odds of patient satisfaction with general health care services (OR, 95%CI-237.6, 70.4-801.5), hospital services (OR, 95%CI-166.9, 67.9-410.6), and physician services (OR, 95%CI-176.5, 63.89-487.3). In contrast, self-perceived unmet health care needs negatively predict patient satisfaction across all health care services: general health care services (OR, 95%CI-0.59, 0.37-0.93), hospital services (OR, 95%CI-0.41, 0.21-0.77), and physician services (OR, 95%CI-0.29, 0.13-0.69). Other negative predictors of patient satisfaction include some post-secondary education (OR, 95%CI-0.36, 0.18-0.72) for general health services and (OR, 95%CI-0.26, 0.09-0.80) for physician services. Those with secondary (OR, 95% CI-0.32, 0.13-0.76) and post-secondary graduation (OR, 95%CI- 0.28, 0.11-0.67) negatively predicted patient satisfaction among users of physician services while being an emergency room patient most recently (OR, 95%CI- 0.39, 0.20-0.77) was also negatively associated with patients satisfaction among hospital services users. CONCLUSION: This study found self-perceived unmet health care needs as a significant negative predictor of neurological patients' satisfaction across health care services and emphasizes the importance of ensuring coordinated efforts to provide appropriate and accessible care of the highest quality for Canadians with neurological conditions.

Relationship Between Spirituality, Religiosity, and General Life Satisfaction Among Canadians Living with Neurological Conditions in New Brunswick and Manitoba.

This study assessed the association between religion and spirituality on general life satisfaction among a sample of community-dwelling Canadians with neurological conditions. The data represented responses from two provinces that participated in the national Canadian Community Health Survey-Annual Component (CCHS-2011). A weighted subsample (n = 4562) of respondents with neurological conditions from the provinces of New Brunswick and Manitoba was used. Multivariate logistic regression fitted the models using STATA version 14. Spiritual coping, self-perceived general, and mental health were found to be predictors of greater life satisfaction and quality of life. It may be beneficial to incorporate spiritual and religious needs in the circle of care for those living in the community with neurological conditions.

Research Review: Developmental origins of depression - a systematic review and meta-analysis.

BACKGROUND: Many observational studies have found a direct association between adverse in utero, perinatal and postnatal exposures and offspring's depression. These findings are consistent with the 'developmental origins of disease hypothesis'. But no review has comprehensively summarized the roles of these exposures. This review aims to systematically scrutinize the strength of associations between individual prenatal, perinatal, and postnatal exposures and subsequent depression in offspring. METHODS: We conducted a systematic review and meta-analysis to synthesize the literature from the EMBASE, HealthStar, PsychoInfo, and Medline databases since their inception to September 1, 2019. English language articles on population-based prospective cohort studies examining the associations between in utero, perinatal, and postnatal exposures and offspring's depression were searched. Random-effects models were used to calculate pooled estimates, and heterogeneity and sensitivity tests were conducted to explore potential confounders in the relationships of depression and early-life factors. Qualitative analysis was also conducted. RESULTS: Sixty-four prospective cohort studies with 28 exposures studied in the relationships to offspring's depression met inclusion criteria. The meta-analysis found 12 prenatal, perinatal, and postnatal characteristics were associated with an increased risk of depression in offspring: low birth weight, premature birth, small gestational age, maternal education, socioeconomic status, having younger parents (<20 years), having older parents (≥35 years), maternal smoking, paternal smoking, maternal stress, maternal anxiety, and prenatal depression. Heterogeneity and sensitivity tests supported the findings. By and large, study characteristics had no effects on conclusions. Qualitative analyses generally supported the findings of meta-analysis and reported on additional risk factors. CONCLUSIONS: This review provides a robust and comprehensive overview of the lasting psychopathological effects of in utero, perinatal, and postnatal exposures. The findings highlight the need for clinical and public health interventions focusing on the identified risk factors. Large prospective cohort studies are warranted to investigate the combined effects of multiple co-existing early-life exposures.

First trimester antenatal care visit reduces the risk of miscarriage among women of reproductive age in Ghana.

Miscarriage is a common adverse pregnancy outcome in childbearing and an increasing global reproductive health problem. This study explored 1) the national prevalence of the first trimester (≤12 weeks) miscarriage among women (15-49 years) in Ghana, and 2) the influence of first-trimester antenatal care (ANC) visits on miscarriage risk. A cross-sectional study using the Demographic Health Survey (DHS- 2017) on maternal health in Ghana was conducted. We used a nationally representative subsample of (7,846) women with no or early ANC visit of the initial sample (25,062). Women with late ANC visit (≥12 weeks) and those who were never pregnant or had not given birth at the time of the survey were excluded from this analysis. We performed multivariable Poisson regression to estimate miscarriage risk (RR), its associated risk factors, and national prevalence. The national first-trimester miscarriage prevalence was 19.1%. Increasing maternal age and urban residence were significantly associated with the risk of first- trimester miscarriage (p <0.001) while early ANC visits lower the risk of miscarriage by 43% (p=0.0246). We found that first trimester ANC visit decreases miscarriage risk in Ghana and highlights the important role of early ANC visits in reducing miscarriages.

Social Support and Positive Coping Skills as Mediators Buffering the Impact of Childhood Maltreatment on Psychological Distress and Positive Mental Health in Adulthood: Analysis of a National Population-Based Sample.

There is little research on how childhood maltreatment influences the use of resilience mechanisms that are key to mental health outcomes in the face of adversity. We assessed the mediating roles of social support and positive coping skills in the relationships between childhood maltreatment and both psychological distress and positive mental health. We analyzed data from a national population survey, the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH 2012, n = 25,113). Confirmatory factor analysis and structural equation modeling were used to model the relationships between childhood maltreatment, social support, and positive coping skills and their direct and mediated effect on psychological distress and positive mental health. Childhood maltreatment was found to be negatively associated with social support, positive coping skills, and positive mental health but positively associated with psychological distress. Social support and positive coping skills predicted higher rates of positive mental health but lower rates of psychological distress. Social support and positive coping skills partially mediated the negative consequences of childhood maltreatment on mental health outcomes. Surprisingly, no sex differences were observed among these associations. This research clearly demonstrates that social support and positive coping skills can mediate the negative impact of childhood maltreatment on mental health.

Baseline income, follow-up income, income mobility and their roles in mental disorders: a longitudinal intra-generational community-based study.

BACKGROUND: Although a number of studies have found that income mobility associated with an elevated risk of mental disorders, existing research does not provide sufficient evidence of how exactly individuals' experience of income mobility per se affects their risk of mental health outcomes. This present study aimed to explore roles of baseline income, follow-up income, and income mobility in the development of mental disorders using an intra-generational, longitudinal follow-up study. METHODS: We used data from the Montreal South-West Longitudinal Catchment Area Study. A total of 1117 participants with complete information both on income and past 12-month diagnoses of mental disorders were selected for this study. Diagonal Reference Models were used to simultaneously examine roles of income at baseline, income at follow-up, and income mobility in mental disorders during a 4-year follow-up. RESULTS: Both baseline and follow-up income were important predictors for any mental disorder and major depression among males and females. Those with low income had a higher risk of any mental disorders and major depression. No evidence was found to support an association between income mobility (neither downwards nor upwards) and mental disorders. Marital status was uniquely associated with any mental disorder among males. Having a pre-existing diagnosis of any mental disorder at origin was associated with any mental disorder and major depression at the end of the 4-year follow-up. CONCLUSIONS: This study first simultaneously examined roles of income at baseline, at follow-up, and mobility in mental disorders among a large-scale intra-generational community-based study. This present study provides additional evidence on how income is associated with an individuals' likelihood of mental disorders.

Alcohol Use Disorder and the Persistence/Recurrence of Major Depression: Le trouble de l'usage de l'alcool et la persistance/récurrence de la dépression majeure.

OBJECTIVE: This study aims to determine the role of alcohol use disorder and other potential risk factors on persistence/recurrence of major depression in a Canadian population sample. METHODS: Data were drawn from the National Population Health Survey (1994/1995 to 2010/2011), a prospective epidemiologic survey of individuals 12 years and older, living in 10 Canadian provinces (N = 17,276). Participants were reinterviewed every 2 years for 9 cycles. This study population was a cohort of individuals who at baseline met the diagnosis of a major depressive episode (MDE) in the previous 12 months (n = 908). After the 6-year (cycle 4) and 16-year (cycle 9) follow-up period, 124 of 718 participants and 79 of 461 participants met the criteria for MDE, respectively. Persistence or recurrence of major depression was defined as meeting a diagnosis of MDE after 6 years and 16 years. Modified Poisson regression models were used to assess the role of alcohol dependence and other risk factors on the persistence/recurrence of major depression using Stata 14. RESULTS: Alcohol use disorder was significantly correlated with a 6-year (odds ratio [OR]: 3.03; 95% confidence interval [CI], 1.68 to 5.48; P < .0001) and 16-year (OR, 3.17; 95% CI, 1.15 to 8.77, P = 0.003) persistence/recurrence of major depression. Other factors associated with the persistence/recurrence of major depression include female sex, childhood traumatic events, chronic pain restricting activities, daily smoking, and low self-esteem. CONCLUSIONS: Comorbid alcohol use disorder was found to be a strong risk factor for the persistence or recurrence of major depression.

Depression risk and body mass index among immigrants and non-immigrants in Canada: results from the Canadian Community Health Surveys, 2010-2014.

PURPOSE: Obesity has been associated with an increased risk of the depression in the general population, but it is unknown whether this relationship applies equally to immigrants as well as non-immigrants. Furthermore, the nature of the relationship is uncertain, is it direct or curvilinear? The aim of this study is to examine the relationship between body mass index and major depressive episode among immigrants and non-immigrants. METHODS: To provide more statistically robust data, a series of cross-sectional health surveys of the Canadian population for the 5 years 2010-2014 were pooled to increase the number of immigrants in the study. Restricted cubic splines analysis was used to examine the nature of the association. RESULTS: Immigrants had lower 12-month depression and obesity prevalence rates than non-immigrants. In addition, it was found that non-immigrants were more likely to develop depression than immigrants, OR = 1.40 (95% CI, 1.16-1.67). Obese respondents were more likely to develop depression than normal weight respondents in both immigrant (OR = 1.55; 95% CI, 1.03-2.32) and non-immigrant groups (OR = 1.23; 95% CI, 1.15-1.32). A significant nonlinear elongated J-shaped association between obesity and depression was found for both immigrants and non-immigrants with increased risk of depression in obese individuals. CONCLUSION: Culture-specific, clinical-based interventions should be developed to improve the early identification, treatment and recovery of individuals with a high BMI particularly among those with BMIs in the obese range.

Pain and self-rated health among middle-aged and older Canadians: an analysis of the Canadian community health survey-healthy aging.

BACKGROUND: Pain is an important health problem adversely affecting functionality and quality of life. Though self- rated health (SRH) is a major predictor of mortality, its relationship with pain is not well understood. We explore 1) how pain and age interact to influence SRH, and 2) provincial variations in SRH across Canada. METHODS: We analyzed cross-sectional data from Statistics Canada's Canadian Community Health Survey-Healthy Aging (n = 30,685), which targeted those 45 years and older and was conducted from 2008 to 12-01 to 2009-11-30. The response rate was 74.4%.The topics covered included socio-demographics, well-being and chronic diseases. We performed both bivariate and multivariate analyses between each predictor and SRH; unadjusted and adjusted odds ratios and 95% confidence intervals are reported. Two-level logistic regression mixed model was used to account for provincial differences. An intraclass correlation coefficient was also computed. RESULTS: Slightly more than half of respondents (56.40%) were female. In bivariate analyses, those experiencing pain had an odds ratio of 0.20. Which means that the odds of reporting good self-rated health are 4 to 5 times lower for those with pain, compare to the odds of reporting good self-rated health among those without pain (p < 0.001). In multivariate analyses the highly educated, female gender, the never married or single and households with high yearly income were predictors of good health (p < 0.001). Those who reported depressive symptoms, the lonely, the obese, daily smokers and/or the stressed were less likely to rate their health as good (p < 0.001). The influence of pain on SRH was stronger among younger age groups (45-54 years) compared to older age groups (75-84 years, with an odds ratio of 3.53 [p < 0.001] versus 3.14 [p < 0.001]). CONCLUSIONS: Pain, among other determinants, is associated with SRH. Individuals in rating their health may consider a variety of factors, some of which may not be apparent to health providers. We found that those who reported depressive symptoms, were daily smokers, the obese, the lonely, and/or having a stressful life were less likely to rate their health as good. No significant provincial variations in SRH in Canada was observed in this study.

Resilience and protective factors among people with a history of child maltreatment: a systematic review.

PURPOSE: To provide an overview of resilience and protective factors associated with a better life following child maltreatment exposure, to compare protective factors across specific subtypes of maltreatment, and to explore existing issues in the current state of the literature. METHODS: Electronic databases and grey literature up to October 2017 were systematically searched for English language with observational study designs for the research on resilience and childhood maltreatment. Systematic review and qualitative approaches were used to synthesize the results. Study quality and heterogeneity were also examined. RESULTS: Initial screening of titles and abstracts resulted in 247 papers being reviewed. A total of 85 articles met eligibility criteria of this review. Most of these studies had low or middle study quality. There were two subgroups of studies reviewed: (1) 11 studies examined whether resilience protected against the negative consequence of childhood maltreatment, and, (2) 75 studies explored what protective factor was associated with a kind of adaptive functioning. Although the conceptualization of resilience significantly varied from study to study, protective factors associated with resilience at individual, familial, and societal levels reduced the likelihood of negative consequences of childhood maltreatment. Negative consequences following childhood maltreatment can be prevented or moderated if protective factors are provided in time. Future research needs to address the conceptualization issue of resilience. CONCLUSIONS: Public and population mental health preventions should focus on early childhood and apply preventive strategies as early as possible. Cost-effective studies should be considered in the evaluation of resilience prevention program.

Gender moderates the relationship between childhood abuse and internalizing and substance use disorders later in life: a cross-sectional analysis.

BACKGROUND: Although some studies examined the moderating role of gender in the relationship between childhood maltreatment and mental disorders later in life, a number of them examined the effects of only one or two types of maltreatment on an individual mental disorder, for instance, depression, substance use. It is of considerable clinical and theoretical importance to have in-depth understanding what roles of different types of childhood abuse play out in a wide range of mental disorders among women and men using well accepted instruments measuring abuse and mental disorders. The present study aimed to examine this issue using a large nationally representative population sample to explore the gender effect of different types of childhood abuse in mental disorders, and assess the moderating role of gender in the abuse-mental disorder relationship. METHODS: Using data from the Canadian Community Health Survey 2012: Mental Health we sought to answer this question. Respondents with information on childhood maltreatment prior to age 16 were selected (N = 23, 395). RESULTS: We found: i) strong associations between childhood abuse frequency and gender; ii) significant differences between men and women in terms of mental disorders; iii) strong associations between childhood abuse and mental disorders; and, iv) gender moderated the role of childhood abuse history on adulthood mental disorders. Females with a history of sexual abuse and/or exposure to interpersonal violence were at a greater risk of alcohol abuse or dependence later in life. CONCLUSIONS: Intervention should occur as early as possible, and should help female victims of childhood sexual abuse and/or exposure to interpersonal violence, and their families to build more constructive ways to effectively reduce the negative affects of these experiences. Recognition of the moderating role of gender on the relationship between childhood abuse history and mental disorders later in life may aid clinicians and researchers in providing optimal health services.

Adjunctive huperzine A for cognitive deficits in schizophrenia: a systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to examine the efficacy of huperzine A (HupA), an isolate of Huperzine serrata, in the treatment of cognitive deficits in schizophrenia spectrum disorders. METHODS: PubMed, PsycINFO, Embase, Cochrane Library, Cochrane Controlled Trials Register, WanFang, Chinese Biomedical, and China Journal Net databases were searched from inception to 15 July 2015 for randomized controlled trials (RCTs) in English or Chinese of HupA augmentation of antipsychotic drug therapy versus placebo or ongoing antipsychotic treatment. RESULTS: Twelve RCTs (n = 1117) lasting 11.7 ± 6.0 weeks met inclusion criteria. All had been conducted in China. HupA outperformed comparators on the following outcome measures: the Wechsler Memory Scale-Revised including memory quotient (weighted mean difference (WMD: 10.59; 95% confidence interval (CI): 5.65, 15.53; p < 0.0001); Wechsler Adult Intelligence Scale-Revised including verbal intelligence quotient (IQ), performance IQ, and full IQ (WMD: 3.97 to 5.66; 95%CI: 0.20, 8.58; p = 0.01 to 0.00001); Wisconsin Card Sorting Test including response administer and non-perseverative errors (WMD: -12.79 to -12.29; 95%CI: -23.70, -0.88; p = 0.03 to 0.003). In studies using the Positive and Negative Syndrome Scale (n = 7)/Brief Psychiatric Rating Scale (n = 1), the differences in total score were significant (standard mean difference: -0.77; 95%CI: -1.27, -0.27; p = 0.002). All-cause discontinuation (risk ratio: 0.67; 95%CI: 0.36, 1.24; p = 0.20) and adverse events were similar between groups. CONCLUSIONS: This review suggests that adjunctive HupA is an effective choice for improving cognitive function for patients with schizophrenia spectrum disorders. More well-designed RCTs are needed to further confirm HupA's efficacy. Copyright © 2016 John Wiley & Sons, Ltd.

Comorbidity between lifetime eating problems and mood and anxiety disorders: results from the Canadian Community Health Survey of Mental Health and Well-being.

This study was to examine profiles of eating problems (EPs), mood and anxiety disorders and their comorbidities; explore risk patterns for these disorders; and document differences in health service utilization in a national population. Data were from the Canadian Community Health Survey of Mental Health and Well-being. The lifetime prevalence of EPs was 1.70% among Canadians, compared with 13.25% for mood disorder, 11.27% for anxiety disorder and 20.16% for any mood or anxiety disorder. Almost half of those with EPs also suffered with mood or anxiety disorders. A similar pattern in depressive symptoms was found among individuals with major depression and EPs, but individuals with EPs reported fewer symptoms. Factors associated with the comorbidity of EPs and mood and anxiety disorders were identified. Individuals with EPs reported more unmet needs. Patients with EPs should be concomitantly investigated for mood and anxiety disorders, as similar interventions may be effective for both.

Successful aging in Canada: prevalence and predictors from a population-based sample of older adults.

BACKGROUND: Little research has been conducted to thoroughly explore the prevalence and predicators of successful aging (SA) from a national point of view. OBJECTIVES: The objectives of this study were (1) to estimate the prevalence of SA as defined by Rowe and Kahn using a large population-based dataset and (2) to determine the roles of sociodemographic, psychological, and lifestyle factors in SA among Canadian seniors. METHODS: Data was from the Canadian Community Health Survey: Healthy Aging (CCHS-HA) (n = 25,864) conducted in 2008-2009. Rowe and Kahn's concept was used to measure SA. Descriptive analyses were used to estimate the prevalence of SA in those aged 45+ living in private dwellings in the ten provinces of Canada. Multivariate logistic regression was used to assess predicators of SA among those aged 65+ and having complete data on cognition. RESULTS: The prevalence of SA was 50.1% among those aged 50+, then decreased to 46.2% for those aged 55+, 42.0% for those aged 60+, and 37.2% among those aged 65+. Assuming those 65+ living in institutions as unsuccessful agers, then the prevalence of SA was 35.3% among Canadian seniors aged 65+. There were no differences in prevalence rate of SA between males and females. We did not find higher income associated with SA. Being younger, married, regular drinkers, exercisers, perceived better health, satisfied with life, and taking calcium in the past month were associated with SA. The predicted probability of being a successful ager was 41% for those aged 65-74 years, 33% for 75-84 years, and 22% for those 85+ years, while controlling for other covariates. Presence of disease led to a major decline in SA, levels of functioning and engagement in contrast remained relatively constant. CONCLUSION: Over one third of the seniors in Canada met the criteria for SA, largely because the operationalization of the definition only considered severe chronic diseases that may not be well managed and thus likely to result in functional impairment. The modifiable risk factors identified provide direction for prevention efforts to increase SA at a population level.

Comorbid substance use disorder, major depression, and associated disability in a nationally representative sample.

BACKGROUND: Major depressive disorders (MDD) and substance use disorders (SUDs) are commonly linked to disability, but there is a lack of research on the risk of disability among individuals who have both SUDs and MD in the general population. This study aimed to investigate the associated risk of disability in people with comorbid SUDs- specifically cannabis use disorder, alcohol use disorder, other drug (except cannabis) use disorder, and a major depressive episode using a nationally representative sample. METHODS: The 2012 Canadian Community Health Survey- Mental Health (CCHS-MH) data were analyzed using multilevel logistic regression models. The survey included a nationally representative sample of Canadians aged 15 years and older (n = 25,113) residing in the ten Canadian provinces from January to December 2012. The diagnoses of major depressive episodes (MDE) and the SUDs were derived from the DSM-IV diagnostic criteria using a modified WHO-CIDI instrument, while disability was assessed using the World Health Organization Disability Assessment Score (WHODAS) 2.0. RESULTS: The strongest predictor of disability was found to be comorbidity. Individuals diagnosed with both a SUD and MDE were 4 to 9 times more likely to experience disability, depending on the substance used, compared to those without either diagnosis. LIMITATIONS: The study's cross-sectional design limits causal inferences. CONCLUSIONS: Our research discovered that individuals who have both SUD and MDE are at a significantly higher risk of experiencing disability. This highlights the importance of integrating mental health and addiction services to mitigate the risk of disability and improve overall treatment outcomes.