Sante Mentale au Quebec最新文献

Olfaction is often neglected in psychiatric semiology, despite its clinical relevance and impact on social functioning. The olfactory reference syndrome (ORS), characterized by a false belief that a person emits a foul odor, causes severe distress and disrupts social functioning. This article aims to highlight the importance of olfaction in psychiatric semiology, with a focus on ORS. We present a study of two men with ORS, followed in a psychotic disorder unit, using the CARE criteria. A literature review conducted according to PRISMA guidelines examines 53 studies from PubMed, PsychInfo, Google Scholar, and Cairns. By complementing the clinical presentations, our analysis facilitates a discussion of current knowledge on ORS, refuting, nuancing and validating existing hypotheses regarding its nosography and etiology. We suggest to further explore our understanding of olfaction through its association with emotions, the formation of impressions, and the Theory of Mind. Better grasping how olfaction influences psychological and social functioning could improve diagnostic and therapeutic approaches to ORS in psychiatry.

Objective Therapeutic relationship is a cornerstone in the treatment of schizophrenia. However, certain personal factors on the part of psychiatrists can hinder it, notably the lack of experience with auditory hallucinations. Such factors can lead to a decrease in empathy and, consequently, a negative alteration in the therapeutic relationship. Previous studies have shown that auditory hallucination simulators have a positive impact on mental health professionals. Yet, to our knowledge, no such test has been conducted on the psychiatry resident population. To address this gap, a research team was formed, including voice hearers, psychiatrists, acoustical engineering researchers, qualitative research experts, and actor-authors. This team collaboratively created the first three-dimensional voice simulator (3DV simulator) using binaural sound reproduction technology. The objective of this pilot study is to evaluate the reaction of psychiatry residents to this 3DV simulator. Methods In this exploratory and descriptive study, psychiatry residents (n=12) were included and invited to listen to the 3DV simulator for 15 minutes. Empathy was assessed before and after the 3DV simulation using the Jefferson Scale of Physician Empathy (JSPE©), a scale to evaluate empathy in healthcare professionals. Following the simulation, participants were invited to participate in a brief semi-structured interview consisting of an open-ended and general question about their experiences, along with additional questions. Results Participants (83.3%) found the 3DV simulator interesting and useful. They perceived the simulation as an aid to better understand the patients' experience and to better identify with their lived realities. Our study did not find a statistically significant difference in the total JSPE© score before and after the simulation (p = 0.797). Conclusion This article addresses the need to enhance the empathy of psychiatry residents towards individuals suffering from auditory hallucinations. One uniqueness of this pilot project is how the simulator was designed collaboratively by a multidisciplinary and inclusive team involving voice hearers throughout the research process. The results of this pilot study presented in this article underscore the necessity of continually improving educational interventions to support the development of empathy among psychiatry residents. They also suggest that the 3DV simulator was well-received by the residents, encouraging the conduct of larger-scale studies.

Background The experience of breast cancer diagnosis leads to being confronted with the unknown and uncertainty. In some cases, patients develop symptoms of psychological distress after the diagnosis, which can have a negative influence during and after treatment. In Quebec, there are several breast cancer clinics that appear to offer psychological assessment to patients and psychosocial services during the different phases of the disease. To our knowledge, few Quebec studies have looked at the effectiveness of and access to psychosocial services in times of non-crisis. The COVID-19 pandemic also led to changes in breast clinics (e.g., closure of screening clinics, reception of diagnosis remotely, changes in treatment plans). However, no Canadian study has qualitatively examined patients' experiences of the impact of the pandemic on access and effectiveness of these services. Objectives The first objective of this qualitative study is to describe the perspectives of Quebec women who received a breast cancer diagnosis and/or treatment during the pandemic on the access to and effectiveness of psychosocial services. In addition, the second objective is to identify patient recommendations for improving the well-being of patients receiving psychosocial oncology services. Method As part of this larger project, we conducted semi-structured interviews with 18 Quebec patients (M = 47.05 years, SD = 9.07) diagnosed and/or treated for breast cancer before and during the pandemic. Descriptive analyses performed in MaxQDA allowed us to establish a thematic guide and narrative summaries. Results A minority of participants (n = 6) were offered psychosocial services at the time of their diagnosis. Although not all of them used the resources offered, they appreciated having them available. In contrast, 12 participants did not receive psychosocial resources, and more than half of these women were unsatisfied as they experienced intense psychological distress following diagnosis, which continued during treatment. Many women (n = 12) had to seek help on their own. Conclusion In order to improve the long-term experience of patients in times of crisis and non-crisis in Quebec, the results show that it could be beneficial to offer psychosocial services based on the needs of users, rather than solely on the severity of psychological symptoms.

Objective Common mental disorders, such as anxiety and depression, have many individual and societal consequences. Various treatments are available for people with these diagnoses, including medication and cognitive behavioral therapy. When these disorders are mild or moderate, psychotherapy is the recommended first-line treatment, given its greater long-term efficacy than pharmacotherapy. However, this is not what is observed in practice: medication is much more widely used than psychotherapy, the latter's accessibility being greatly reduced by long waiting lists. An alternative to these accessibility difficulties is the stepped-care model, which includes guided self-help. These are low-intensity interventions that enable more people to be treated with fewer resources (e.g., fewer meetings with a professional). The Programme québécois pour les troubles mentaux (PQPTM; Quebec Program for Mental Disorders) is a stepped-care model recently implemented in some settings in Quebec. The aim of this study is to gather the perceptions of social workers (SWs) in a Centre intégré (universitaire) de santé et de services sociaux (CI[U]SSS; Community mental health center) on the implementation of the PQPTM guided self-help. Methods To this end, three focus groups of approximately 1h30 were conducted with 13 SWs. The data were coded and analyzed using a thematic qualitative inductive-deductive approach, based on the Consolidated Framework for Implementing Research (CFIR) and the participants' responses obtained during the focus groups. Results The barriers and facilitators to PQPTM guided self-help implementation identified relate to different CFIR constructs: intervention characteristics (e.g., monitoring, type of self-help), internal implementation parameters (e.g., training, organizational pressures), caregiver characteristics (e.g., experience, appropriation time), user characteristics (e.g., age, personality) and process (e.g., treatment integrity, supervision). The results of this qualitative study show that SWs have varied perceptions and opinions of the PQPTM guided self-help: 64% of the themes discussed were nuanced, while 25% were considered exclusively as barriers and 11% exclusively as facilitators. Conclusion These results shed light on the factors that can contribute to the successful implementation of the PQPTM guided self-help in Quebec, with a view to improving it at the heart of the specific CI(U)SSS of the current study and in other mental health centers in Quebec. Several recommendations are made in this respect: for example, to increase upstream planning for future implementations, to maintain access to training and supervision, and to guarantee the availability and printing of self-help guides.

Objectives Natural disasters have a significant impact on mental health. Data collected from the population offer a unique opportunity for post-disaster monitoring to help identify psychological support needs. The aim of this study is: 1) to identify psychopathological aspects for the county of Prêcheur at risk from lahars (volcanic lava), and 2) to phenotype psychopathological aspects from data collected from the population. Method We applied an artificial intelligence (AI) assisted psycho-phenotyping method to data from 40 people over a 20-month period, to extract psychopathological and psychiatric aspects linked to traumatic natural hazards. These were then compared with the results of psychometric tests measuring overall mental health and post-traumatic stress. Results Rumination and negativation were among the most important psychopathological aspects identified. In addition, we noted the presence of re-experiencing and avoidance as core psychiatric dimensions over time. Among these, cognitive avoidance and emotional avoidance were found and seem to have emerged after the disaster. Conclusion We have proposed a new syndromic surveillance approach for mental health based on digital data that can support conventional approaches by providing additional useful information in the context of a disaster. Further studies are needed to better control bias, identify associations with valid instruments, and explore computational methods for continuous adjustment of the AI-analysis model.

Objectives To introduce the concept of digital well-being and explore the place of digital tools in the service of this well-being. Methods The article is based on a description of the concept of digital well-being, the intervention models currently available and the possibilities for improvement of these models. Findings Over the past decade, smartphone use has become almost ubiquitous in modern society. The average person spends several hours a day on their device, especially among teenagers and young adults. With smart, interactive, convenient and always-on connectivity, individuals face new challenges and pressures related to when, where, how and how intensively they choose to connect or disconnect from the services provided by the smartphone. Problematic smartphone use has been linked to mental health disorders and functional problems. The concept of digital well-being has recently been introduced to address this challenge of using digital technologies to promote well-being. This is the subjective and individual experience of an optimal balance between the advantages and disadvantages associated with digital technology. Today's interventions are mostly based on technological tools focusing on screen-time control. The results of such interventions are mixed. Conclusion Better integration of dynamic human-machine interfaces may be essential for optimal efficiency of tools aiming to support digital wellbeing.