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1.
Can J Psychiatry ; 65(6): 392-400, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31830819

RESUMO

OBJECTIVES: The purpose of the present study was to assess longitudinal associations between positive and harsh parenting in childhood and adolescent mental and behavioral difficulties. METHODS: Data were drawn from Canada's population-based National Longitudinal Survey of Children and Youth (data collected from 1994 to 2009, analyzed 2018). The sample included 9,882 adolescents aged 12/13 years old. Parents self-reported positive and harsh parenting when children were 6/7, 8/9, and 10/11 years old. Symptoms of depression/anxiety, hyperactivity, physical aggression, social aggression, and suicidal ideation were self-reported by adolescents at age 12/13. Linear regression was used to examine the associations between parenting behaviors at each age and adolescent psychiatric symptoms, adjusted for children's baseline symptoms. RESULTS: Harsh parenting at 10/11 was associated with elevated symptoms of early-adolescent physical aggression, social aggression, and suicidal ideation for boys only, and for all children at earlier ages. Beginning at age 8/9, harsh discipline was associated with elevated symptoms of depression/anxiety for boys only. Overall, positive parenting at age 6/7 was protective against depression/anxiety, physical aggression, and social aggression. Significant sex differences emerged beginning at age 8/9, with positive parenting associated with higher symptoms of depression/anxiety for boys only. Positive parenting at age 10/11 was associated with increased depression/anxiety, physical aggression, social aggression, and suicidal ideation among boys, but decreased symptoms of physical aggression, social aggression, and suicidal ideation among girls. CONCLUSIONS: Results suggest that the impact of positive and harsh parenting may depend on age and sex, with harsh parenting being more detrimental to boys as they approach adolescence.


Assuntos
Saúde Mental , Poder Familiar , Adolescente , Agressão , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais
2.
Can J Psychiatry ; 64(4): 265-274, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30978144

RESUMO

OBJECTIVES: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. METHODS: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y ( n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. RESULTS: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). CONCLUSIONS: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury.


Assuntos
Saúde da Criança/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Feminino , Humanos , Masculino , Ontário/epidemiologia , Prevalência
3.
Healthc Manage Forum ; 32(2): 51-55, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30799661

RESUMO

The current mental health services system in Canada is fragmented and transitions between the youth and adult mental health systems have been identified as needing significant improvement. Integrated Youth Services (IYS) are designed to be adaptable and developmentally appropriate as well as to promote seamless transitions, including during emerging adulthood. This article provides an overview of recent developments in Canadian mental health system transformation to promote the integration of services and the holistic promotion of youth well-being. We offer an overview of the current state of knowledge related to best practices in IYS in Canada and highlight areas for future development. We also introduce Frayme, a Canadian-based international knowledge translation platform designed to connect organizations working in the youth services system to accelerate the implementation of IYS.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Serviços de Saúde Mental/organização & administração , Inovação Organizacional , Adolescente , Serviços de Saúde do Adolescente/organização & administração , Canadá , Política de Saúde , Humanos , Transtornos Mentais/terapia , Pesquisa Translacional Biomédica , Adulto Jovem
4.
Can J Psychiatry ; 60(6): 245-57, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26175322

RESUMO

OBJECTIVE: We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts. METHODS: Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review or meta-analysis; prevention in youth 0 to 24 years; peer-reviewed English literature. Review quality was determined with AMSTAR (a measurement tool to assess systematic reviews). Nominal group methods quantified consensus on recommendations derived from the findings. RESULTS: No included review addressing school-based prevention (n = 7) reported decreased suicide death rates based on randomized controlled trials (RCTs) or controlled cohort studies (CCSs), but reduced suicide attempts, suicidal ideation, and proxy measures of suicide risk were reported (based on RCTs and CCSs). Included reviews addressing prevention of repeat suicide attempts (n = 14) found the following: emergency department transition programs may reduce suicide deaths, hospitalizations, and treatment nonadherence (based on RCTs and CCSs); training primary care providers in depression treatment may reduce repeated attempts (based on one RCT); antidepressants may increase short-term suicide risk in some patients (based on RCTs and meta-analyses); this increase is offset by overall population-based reductions in suicide associated with antidepressant treatment of youth depression (based on observational studies); and prevention with psychosocial interventions requires further evaluation. No review addressed sex or gender differences systematically, Aboriginal youth as a special population, harm, or cost-effectiveness. Consensus on 6 recommendations ranged from 73% to 100%. CONCLUSIONS: Our EKS facilitates decision maker access to what is known about effective youth suicide prevention interventions. A national research-to-practice network that links researchers and decision makers is recommended to implement and evaluate promising interventions; to eliminate the use of ineffective or harmful interventions; and to clarify prevention intervention effects on death by suicide, suicide attempts, and suicidal ideation. Such a network could position Canada as a leader in youth suicide prevention.


Assuntos
Serviços de Saúde Mental/organização & administração , Serviços de Saúde Escolar/organização & administração , Prevenção do Suicídio , Suicídio/estatística & dados numéricos , Adolescente , Canadá , Humanos , Serviços de Saúde Mental/normas , Serviços de Saúde Escolar/normas
5.
Child Adolesc Ment Health ; 18(3): 165-170, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32847251

RESUMO

BACKGROUND: Mental health affects one in five young people, with the majority avoiding help due to stigma. In this study, young people's (n = 49) perception of stigma as a barrier to accessing school-based mental health services was compared with that of service providers (n = 63), along with the perceived extent of mental health problems and availability of school-based mental health resources. METHOD: Participants completed a survey or interview. EBSCO and PubMed databases were used for the duration of this study, from August 2010 to September 2011. RESULTS: A greater proportion of young people versus providers reported stigma as the largest barrier to accessing mental health services. In addition, most young people reported that school-based mental health resources were scarce. CONCLUSIONS: These results emphasize the need for young people's involvement in mental health initiatives.

6.
JAMA Netw Open ; 6(5): e2315479, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-37234010

RESUMO

Importance: People with serious mental illness (SMI), defined as a diagnosis of schizophrenia spectrum disorder, bipolar disorder, or disabling major depressive disorder) die approximately 10 to 25 years earlier than the general population. Objective: To develop the first-ever lived experience-led research agenda to address early mortality in people with SMI. Evidence Review: A virtual 2-day roundtable comprising 40 individuals convened on May 24 and May 26, 2022, and used a virtual Delphi method to arrive at expert group consensus. Participants responded to 6 rounds of virtual Delphi discussion via email that prioritized research topics and agreement on recommendations. The roundtable was composed of individuals with lived experience of mental health and/or substance misuse, peer support specialists, recovery coaches, parents and caregivers of people with SMI, researchers and clinician-scientists with and without lived experience, policy makers, and patient-led organizations. Twenty-two of 28 (78.6%) of the authors who provided data represented people with lived experiences. Roundtable members were selected by reviewing the peer-reviewed and gray literature on early mortality and SMI, direct email, and snowball sampling. Findings: The following recommendations are presented in order of priority as identified by the roundtable participants: (1) improve the empirical understanding of the direct and indirect social and biological contributions of trauma on morbidity and early mortality; (2) advance the role of family, extended families, and informal supporters; (3) recognize the importance of co-occurring disorders and early mortality; (4) redefine clinical education to reduce stigma and support clinicians through technological advancements to improve diagnostic accuracy; (5) examine outcomes meaningful to people with an SMI diagnosis, such as loneliness and sense of belonging, and stigma and their complex relationship with early mortality; (6) advance the science of pharmaceuticals, drug discovery, and choice in medication use; (7) use precision medicine to inform treatment; and (8) redefine the terms system literacy and health literacy. Conclusions and Relevance: The recommendations of this roundtable are a starting point for changing practice and highlighting lived experience-led research priorities as an option to move the field forward.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Transtornos Mentais , Esquizofrenia , Humanos , Transtorno Bipolar/diagnóstico , Transtornos Mentais/epidemiologia , Saúde Mental , Consenso
7.
Can J Public Health ; 103(3): 213-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22905641

RESUMO

OBJECTIVES: We examined whether established sex differences in suicide rates persist when adjustments are made for potential misclassification of deaths in children and youth. METHODS: This is a retrospective, descriptive study of 1294 suicides, 961 accidental and 254 undetermined deaths occurring between January 1, 2000 and December 31, 2007, among persons aged 10 to 25 years in Ontario, Canada. Using data from Coroner's records, causes of death were reclassified based on two different misclassification criteria. Actual and reclassified suicide rates were calculated by sex and age group (with 95% confidence intervals) and by year of death. RESULTS: Males aged 16-25 years accounted for the majority of suicides (68.9%). Asphyxia was the most common cause of suicide in both sexes. While suicides by shooting were almost exclusive to males, suicides due to alcohol/drug toxicity were significantly higher in females. Both before and after reclassification of suicide deaths, sex differences in suicide rates emerged in the 16-25 years age group. In each study year, both actual and reclassified suicide rates were higher in males than females. CONCLUSIONS: Sex differences in suicide rates emerging in adolescence are unlikely to be due to misclassification. Other proposed explanations for sex differences in youth suicide rates should be investigated further.


Assuntos
Caracteres Sexuais , Suicídio/estatística & dados numéricos , Adolescente , Criança , Feminino , Humanos , Masculino , Ontário/epidemiologia , Estudos Retrospectivos , Fatores Sexuais
8.
Adm Policy Ment Health ; 39(4): 238-47, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21461778

RESUMO

There is solid evidence for strategies and programs that, if implemented with fidelity in schools, will enhance the mental health of children and youth. These practices are, however, inconsistently applied and rarely evaluated programmatically in every day practice. In recent years, implementation variables that influence uptake have received attention. An emerging area of interest is the role that research partnerships might play in narrowing the gap between science and practice. Drawing on the literature and practice examples, collaborators from the United States and Canada explore the role of partnerships in bringing the worlds of research and practice closer into alignment.


Assuntos
Transtornos do Comportamento Infantil/prevenção & controle , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Escolar/organização & administração , Instituições Acadêmicas , Pesquisa Translacional Biomédica/métodos , Adolescente , Canadá , Criança , Comportamento Cooperativo , Prática Clínica Baseada em Evidências/métodos , Humanos , Estados Unidos
9.
Ann Emerg Med ; 56(6): 649-59, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20381916

RESUMO

STUDY OBJECTIVE: We evaluate the effectiveness of interventions for pediatric patients with suicide-related emergency department (ED) visits. METHODS: We searched of MEDLINE, EMBASE, the Cochrane Library, other electronic databases, references, and key journals/conference proceedings. We included experimental or quasiexperimental studies that evaluated psychosocial interventions for pediatric suicide-related ED visits. Inclusion screening, study selection, and methodological quality were assessed by 2 independent reviewers. One reviewer extracted the data and a second checked for completeness and accuracy. Consensus was reached by conference; disagreements were adjudicated by a third reviewer. We calculated odds ratios, relative risks (RRs), or mean differences for each study's primary outcome, with 95% confidence intervals (CIs). Meta-analysis was deferred because of clinical heterogeneity in intervention, patient population, and outcome. RESULTS: We included 7 randomized controlled trials and 3 quasiexperimental studies, grouping and reviewing them according to intervention delivery: ED-based delivery (n=1), postdischarge delivery (n=6), and ED transition interventions (n=3). An ED-based discharge planning intervention increased the number of attended post-ED treatment sessions (mean difference=2.6 sessions; 95% CI 0.05 to 5.15 sessions). Of the 6 studies of postdischarge delivery interventions, 1 found increased adherence with service referral in patients who received community nurse home visits compared with simple placement referral at discharge (RR=1.28; 95% CI 1.06 to 1.56). The 3 ED transition intervention studies reported (1) reduced risk of subsequent suicide after brief ED intervention and postdischarge contact (RR=0.10; 95% CI 0.03 to 0.41); (2) reduced suicide-related hospitalizations when ED visits were followed up with interim, psychiatric care (RR=0.41; 95% CI 0.28 to 0.60); and (3) increased likelihood of treatment completion when psychiatric evaluation in the ED was followed by attendance of outpatient sessions with a parent (odds ratio=2.78; 95% CI 1.20 to 6.67). CONCLUSION: Transition interventions appear most promising for reducing suicide-related outcomes and improving post-ED treatment adherence. Use of similar interventions and outcome measures in future studies would enhance the ability to derive strong recommendations from the clinical evidence in this area.


Assuntos
Serviço Hospitalar de Emergência , Serviços de Saúde Mental , Tentativa de Suicídio , Adolescente , Criança , Intervalos de Confiança , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/normas , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Serviços de Saúde Mental/normas , Serviços de Saúde Mental/estatística & dados numéricos , Razão de Chances , Alta do Paciente/normas , Alta do Paciente/estatística & dados numéricos , Encaminhamento e Consulta/normas , Encaminhamento e Consulta/estatística & dados numéricos , Risco , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos
10.
Suicide Life Threat Behav ; 50(6): 1149-1157, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32720746

RESUMO

OBJECTIVE: To investigate longitudinal relationships between parenting practices in childhood and adolescent suicidality, and assess the mediating role of emotional and behavioral symptoms. METHODS: Data were drawn from the National Longitudinal Survey of Children and Youth, a Canadian population-based longitudinal cohort study. The sample included 9,490 children aged 10-11 who were followed up biennially to ages 14-15. Parents reported their positive and punitive parenting practices when children were 10-11. Adolescents self-reported symptoms of depression/anxiety, hyperactivity, conduct disorder, and social aggression at 12-13, and past-year suicidal ideation and suicide attempts at 14-15. RESULTS: The inverse associations between positive parenting at 10-11 and suicidal behaviors at 14-15 were significantly mediated by symptoms of hyperactivity, conduct disorder, and social aggression at 12-13. Direct relationships between punitive parenting and suicidal behaviors were observed. These associations were significantly mediated by hyperactivity and, among boys only, by conduct disorder and social aggression. The association between punitive parenting and suicide attempt was additionally mediated by depression/anxiety. CONCLUSIONS: Parenting in childhood may be associated with adolescent suicidality both directly and indirectly through emotional and behavioral symptoms. Interventions aimed at reducing the use of harsh disciplinary strategies and promoting positive parent-child interactions may reduce the burden of adolescent suicidality.


Assuntos
Poder Familiar , Suicídio , Adolescente , Sintomas Comportamentais , Canadá , Criança , Estudos de Coortes , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos
11.
J Sch Psychol ; 81: 1-10, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32711720

RESUMO

This study examined associations between teacher-student relationship quality at school and teachers' responsiveness to students' emotional concerns in a classroom and (a) students' intention to seek help at school for mental health concerns and (b) mental health-related service use. Data for analyses came from the School Mental Health Survey, a cross-sectional survey of 31,120 grade 6-12 students, in 1968 classrooms, attending 248 schools in Ontario, Canada. Three-level (student, classroom, school) binary logistic regression was used to address the study objectives. Student ratings of the quality of teacher-student relationships and teachers' responsiveness were included as predictors, both at the individual student level and aggregated to represent a contextual level characteristic at the school and classroom level, respectively. At the student level, both teacher-student relationship quality and teacher responsiveness were positively associated with intentions to seek help at school among both elementary and secondary students (ORs ranged from 1.14-1.19 for relationships and 1.06-1.08 for responsiveness). Aggregated to the school level, teacher-student relationship quality was positively associated with mental health service use for secondary students (OR = 1.36, 95% CI [1.10, 1.69]). Positive and responsive teacher-student relationships were associated with help-seeking behaviors among students. Longitudinal studies are warranted to disentangle the temporality of these associations.


Assuntos
Comportamento de Busca de Ajuda , Saúde Mental , Professores Escolares/psicologia , Estudantes/psicologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Masculino , Ontário , Serviços de Saúde Mental Escolar , Instituições Acadêmicas , Inquéritos e Questionários
12.
Early Interv Psychiatry ; 14(4): 495-502, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31943853

RESUMO

AIM: Frayme is a Canadian-based international network designed to accelerate the adoption and scaling up of integrated youth services (IYS). This is done through the synthesis of evidence from a variety of sources and a commitment to integrated knowledge mobilization (KMb) to inform research policy and practice. Frayme is utilizing innovative approaches to stakeholder engagement (youth, families, policy makers, funders, researchers and practitioners) and KMb in order to co-design system change. The purpose of this article describes the overall Frayme strategy and presents findings from a participatory needs assessment implemented to inform policy-related priorities. METHODS: The Frayme leadership team facilitated a participatory needs assessment with major stakeholder groups that applied a modified problem-solving activity. The needs assessment was on a designed to support diverse stakeholder perspectives on ways to improve knowledge mobilization of IYS. Qualitative data were analysed using a thematic analysis. RESULTS: The four themes identified through the needs assessment were: (a) traditional scientific practices, (b) organizational obstacles, (c) change aversion, and (d) pre-established stakeholder hierarchies. CONCLUSIONS: Through the recognition of these challenges, Frayme has developed a set of major objectives to inform projects, opportunities for knowledge sharing, implementation of evidence and scaling up of efforts. The Frayme integrated KMb model represents a unique applied example of an evidence-informed approach to practice collaboration in KMb to promote system change. The findings from this research also contribute to the expanding knowledge base with regard to complex evaluation and system transformation.


Assuntos
Serviços de Saúde do Adolescente/organização & administração , Avaliação das Necessidades , Desenvolvimento de Programas/métodos , Adolescente , Canadá , Humanos , Pesquisa Qualitativa
13.
Early Interv Psychiatry ; 14(1): 3-13, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31960595

RESUMO

AIM: Over the past two decades, the youth mental health field has expanded and advanced considerably. Yet, mental disorders continue to disproportionately affect adolescents and young adults. Their prevalence and associated morbidity and mortality in young people have not substantially reduced, with high levels of unmet need and poor access to evidence-based treatments even in high-income countries. Despite the potential return on investment, youth mental disorders receive insufficient funding. Motivated by these continual disparities, we propose a strategic agenda for youth mental health research. METHOD: Youth mental health experts and funders convened to develop youth mental health research priorities, via thematic roundtable discussions, that address critical evidence-based gaps. RESULTS: Twenty-one global youth mental health research priorities were developed, including population health, neuroscience, clinical staging, novel interventions, technology, socio-cultural factors, service delivery, translation and implementation. CONCLUSIONS: These priorities will focus attention on, and provide a basis for, a systematic and collaborative strategy to globally improve youth mental health outcomes.


Assuntos
Saúde Global/tendências , Transtornos Mentais/terapia , Saúde Mental/tendências , Pesquisa/tendências , Adolescente , Criança , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Masculino , Transtornos Mentais/epidemiologia , Resultado do Tratamento , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-30733825

RESUMO

BACKGROUND: While considerable progress is being made to understand the health and self-management needs of youth with mental health disorders, little attention has focused on the mental health and recovery needs that the youth themselves identify-this despite a national priority to incorporate patient-oriented research into the development and assessment of mental health services. To address this gap, estimates of the extent to which existing patient-reported outcome measures (PROMs)-originally developed for use amongst adult populations-are clinically meaningful and psychometrically fit for use among youth are needed. In tandem, a recovery profile for youth can be constructed incorporating the youth perspective of the services provided within a community mental health setting. METHODS/DESIGN: This study will utilize a mixed methods design incorporating qualitative focus group interviews and cross-sectional survey. Our process will begin with the hiring of a youth peer research partner who will provide lived experience expertise through all phases of the study. We will advertise, recruit, and conduct four focus groups with youth who receive services from the Foundry Vancouver Granville located in British Columbia, Canada. In the first two focus groups, we will recruit youth aged 15-18 years (n = 10). In the second two focus groups, we will recruit young adults aged 19-24 years (n = 10). In parallel, we will conduct a cross-sectional survey of the recovery and mental health needs of youth, informed by ten widely used and validated PROM. Thematic analysis techniques will guide the identification of predominant thematic trends in the qualitative focus group data. We will use Classical and Rasch measurement methods to test and analyze the reliability and validity of selected PROM measures for youth populations. DISCUSSION: The proposed study has the potential to produce a preliminary conceptual and measurement model for understanding the mental health and recovery needs of youth with mental health disorders. This evidence will inform how youth mental health services can grow, support, and sustain the capacity for a collaborative, interdisciplinary and innovative patient-oriented research environment. Findings will also contribute much needed evidence to improve the standard of care for youth who experience mental health disorders in Canada and beyond.

15.
J Am Acad Child Adolesc Psychiatry ; 47(2): 174-179, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18176332

RESUMO

OBJECTIVE: To prospectively identify and assess withdrawal symptoms in adolescents with cannabis dependence. METHOD: Twenty-one adolescents ages 13 to 19 years voluntarily entering residential and day/outpatient substance abuse programs, with cannabis dependence as their only current substance of dependence, were assessed using the Teen-Addiction Severity Index, Substance Use Survey, Cannabis Withdrawal Scale, and the Structured Clinical Interview for DSM-IV Childhood Diagnoses Substance Use Disorders Module. Weekly assessments continued for 4 weeks. Thirteen youths attained a minimum of 2 weeks of abstinence. RESULTS: Cannabis withdrawal symptoms were present in adolescents. Cannabis withdrawal was greatest in the first 2 weeks of abstinence with evidence that it continued well into week 3. Most withdrawal symptoms were endorsed with a high degree of frequency. Those symptoms endorsed with the greatest severity were restlessness, appetite change, and thoughts of and cravings for cannabis, with the highest ratings occurring in week 1. Over the course of the study, participants reported fewer symptoms with decreasing levels of severity. Youth ratings of overall severity of withdrawal were significantly and positively correlated with withdrawal symptoms of irritability (r = 0.56), depression (r = 0.56), twitches and shakes (r = 0.57), perspiring (r = 0.57), thoughts of (r = 0.86), and cravings for (r = 0.69) cannabis. CONCLUSIONS: Findings support the presence of clinically significant cannabis withdrawal symptoms in adolescents with cannabis dependence seeking substance abuse treatment. This study also provides supporting evidence suggesting a vulnerability of adolescents to physiological cannabis dependence. The study supports the addition of cannabis withdrawal as a distinct entity for inclusion in DSM-V.


Assuntos
Canabinoides/efeitos adversos , Abuso de Maconha/reabilitação , Síndrome de Abstinência a Substâncias/etiologia , Adolescente , Hospital Dia , Feminino , Humanos , Masculino , Exame Neurológico/efeitos dos fármacos , Medição da Dor , Projetos Piloto , Estudos Prospectivos , Centros de Tratamento de Abuso de Substâncias , Síndrome de Abstinência a Substâncias/diagnóstico
16.
Int J Integr Care ; 18(4): 10, 2018 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-30515072

RESUMO

Integrated youth service (IYS) is a collaborative approach that brings practitioners together from across disciplines to provide comprehensive services including mental health care for youth and their families. IYS models serve as an advancement in practice as they go beyond the capacity of individual programs and services to reduce the fragmentation of care. Yet, there continue to be opportunities to expand on this perspective and promote health beyond the scope of formalized services. The bioecological model is a theoretical model that examines individual development within multiple systems of influence as well as through interactional processes between the individual and their environment. This paper provides an overview of the bioecological model and the major components of the IYS model, describing alignment and complementarity. The bioecological model provides some explanations for why IYS models may be effective and helps to provide direction to expand applied practice toward a more holistic perspective.

17.
J Am Acad Child Adolesc Psychiatry ; 42(7): 778-85, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12819437

RESUMO

OBJECTIVE: This cross-sectional study explored differences in and the association of self-reported coping style, negative life events, self-esteem, and perceived social support with the psychological adjustment (i.e., depressive symptoms, internalizing and externalizing behavior problems) of homeless and nonhomeless adolescent males. METHOD: Data were collected from 100 youths accessing an emergency shelter and two comparison groups of nonhomeless youths: 70 youths accessing local community drop-in centers and 54 high school youths who had never accessed a shelter or drop-in. Data were collected from January 2000 to January 2001 in Ottawa. RESULTS: Homeless youths reported a higher prevalence of family dysfunction, school difficulties, suicide attempts, legal problems, and substance use than nonhomeless youths. Homeless youths differed from nonhomeless youths for each outcome measure, reporting a greater use of the disengagement coping style, higher negative life events index, less perceived parental support, and higher levels of depressive symptoms and internalizing and externalizing behavior problems. Hierarchical regression analyses indicated that disengagement coping and self-worth accounted for significant amounts of variance in depressive symptomatology, and both internalizing and externalizing behavior problems in homeless youths. CONCLUSIONS: Findings reflect the merit of considering coping style as a factor in the prevalence of psychological maladjustment among homeless youths.


Assuntos
Adaptação Psicológica , Transtornos de Adaptação/psicologia , Pessoas Mal Alojadas/psicologia , Transtornos de Adaptação/epidemiologia , Adolescente , Adulto , Depressão/epidemiologia , Depressão/psicologia , Humanos , Masculino , Prevalência , Análise de Regressão , Apoio Social , Inquéritos e Questionários
18.
J Adolesc Health ; 34(3): 237-43, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-14967348

RESUMO

PURPOSE: To evaluate the association among suicide behaviors, high-risk behaviors, coping style, and psychological adjustment (i.e., depressive symptomatology, internalizing and externalizing behavior problems) in homeless and non-homeless adolescent males (aged 16 to 19 years). METHODS: Data were obtained from 100 homeless youth accessing an emergency shelter (Ottawa, ON). The comparison group was comprised of 70 youth accessing local community drop-in centers that lived with their parent(s)/guardian(s) and had never stayed in a shelter. Data were analyzed using Chi-square, Student's t-tests, and regression statistics. RESULTS: Relative to non-homeless youth, homeless youth were more likely to report drug, alcohol, and tobacco use, legal problems, academic difficulties, and mental health problems. Homeless youth presented with a higher prevalence of suicidal ideation, past suicide attempts, depressive symptomatology, and internalizing and externalizing behavior problems. Disengagement coping was a predictor of suicidal ideation, past attempts, depressive symptoms and both internalizing and externalizing behavior problems in homeless youth. CONCLUSIONS: Relative to non-homeless youth, findings indicate that homeless youth reported greater use of a disengaging coping style and are at greater risk for high-risk behaviors, past suicide attempts, and clinically elevated levels of depressive symptoms and behavior problems.


Assuntos
Adaptação Psicológica , Comportamento do Adolescente , Jovens em Situação de Rua/psicologia , Assunção de Riscos , Suicídio , Adolescente , Humanos , Masculino , Ontário
19.
J Marital Fam Ther ; 28(4): 391-8, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12382548

RESUMO

Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with chronically ill children who received treatment were assessed to determine if the significant improvement in relationship distress observed at posttreatment and 5-month follow-up would be maintained at 2-year follow-up. Results demonstrated that improvements in marital functioning were not only maintained but, in some cases, enhanced at the 2-year follow-up. This uncontrolled follow-up study provides initial evidence of the longer-term benefits of EFT.


Assuntos
Adaptação Psicológica , Doença Crônica/psicologia , Efeitos Psicossociais da Doença , Terapia Conjugal/métodos , Casamento/psicologia , Pais/psicologia , Análise de Variância , Criança , Pré-Escolar , Características da Família , Feminino , Seguimentos , Humanos , Masculino , Ontário , Cônjuges/psicologia , Estresse Psicológico/etiologia , Fatores de Tempo , Resultado do Tratamento
20.
Paediatr Child Health ; 2(6): 398-399, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33033438

RESUMO

Today's youth are at a disturbingly high risk for mental health and illness problems and are largely dissatisfied with the existing mental health services. Youth Net/Réseau Ado (YN/RA), supported by input from mental health professionals, is a bilingual mental health promotion program that seeks out the opinions and attitudes of youth regarding mental health and illness issues, while connecting them with appropriate resources and mental health services. This paper describes the Youth Net/Réseau Ado program and provides some guidelines for the identification of mental health and illness problems, including indicators of the risk of suicide.


Les adolescents d'aujourd'hui présentent un risque inquiétant de troubles psychologiques ou affectifs et se montrent très insatisfaits face aux services existants en santé mentale. Réseau ado/Youth Net (RA/YN), soutenu par l'apport des professionnels de la santé, est un programme bilingue de promotion de la santé mentale qui cherche à solliciter les opinions et les attitudes des adolescents au sujet de la santé mentale et des maladies s'y reliant, tout en orientant ceux-ci vers les ressources et les services pertinents. Cet article décrit le programme Réseau ado/Youth Net et contient des directives pour identifier les troubles de santé et de maladie mentale, y compris les indicateurs de risque de suicide.

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