Sante Mentale au Quebec最新文献

Background Created in 2004, the Eli Lilly Canada Chair on schizophrenia research was funded by Eli Lilly, the Institut universitaire en santé mentale de Montréal, Hôpital Sacré-Coeur and Centre hospitalier de l'Université de Montréal. The aim of this article is to provide an historical overview of the scientific activities of the Chair since its inception. Method In order to carry out this historical account, we adopted a bibliometric approach. We carried out a PubMed search of all articles published by any of the Chair holders since its creation in 2004. Once the articles had been identified, we counted all the times they had been cited in the literature. This was done using Google Scholar. We also counted the main themes addressed in these articles. We adopted an externalist perspective for the interpretation of the scientific work. Results Since its creation in 2004, the Chair has published a total of 295 scientific articles, which have been cited 12,892 times. The main themes addressed in these articles are cognition, neuroimaging and antipsychotics, followed by addiction, psychosocial interventions and treatment resistance. The most influential articles showed the presence of an inflammatory syndrome and sleep difficulties in schizophrenia, in addition to corroborating the aberrant salience hypothesis of psychosis, disproving the lateralization of language hypothesis in schizophrenia, and establishing links between antipsychotic treatment and COVID-19. Discussion From an externalist perspective, the evolution of the Chair's work has been influenced by important factors external to the logic of scientific discovery, namely the commercialization of several antipsychotics during the 1990s-2000s, the relative democratization of neuroimaging during the 2000-2010s, the legalization of cannabis use for recreational purposes in 2018 in Canada, and the rise of digital health-notably virtual reality-over the past decade. Conversely, the focus on the neurobiology of violent behavior and the tendency to publish in French-language journals are trends that run counter to current social trends. The article concludes with a reflection on the nature of the concept of psychosis.

The objective of this perspective article is to explore the creation of a new syndrome specific to the Canadian city of Montreal: Conophobia. In a more academic way, the aim is to think about the process which leads to the creation of a new clinical entity and to question how the name of a disease is chosen. In the literature, it is illustrated by syndromes with a name of a city: Stockholm syndrome, Stendhal syndrome, Pisa syndrome, Havana syndrome, Paris syndrome, Lima syndrome or Copenhagen syndrome. Conophobia is a neologism reflecting a potential syndrome linked to the growing observation of an original suffering invading the metropolis of Quebec: anxiety in relation to a clearly identified object that we calls the Cone. New traffic cones have in fact appeared on the streets, by the thousands dotted throughout the neighborhoods, to mark the start of work on public roads. In the context of this invasion, the first observable behavioral anomalies appeared in the population, signs of suffering, and feelings of helplessness among citizens. Media coverage appeared. Almost 30% of orange cones in a given area remained on the streets for no apparent reason, causing unnecessary obstruction and aesthetic nuisance. We were able to observe some vignettes of this phenomenon which cannot be called a clinical vignette at this stage but which in many respects shares links with phobias. Videos that went viral on the networks even showed individuals in several places enraged by the road works, getting out of their cars, grabbing orange cones and throwing them onto the ground next to the street. To our knowledge, there have yet been no hospitalizations or visits to the emergency unit specifically due to a cone. This new semiology or phenomenology can lead the clinician to be attentive to a possible shift in behavior from normal to pathological. The cursor which demarcates this border needs to be studied. The so-called Montreal syndrome allows us to think about the link between mental health and the identity of a city. This relation needs to be improved. Aid and therapies for individuals already suffering from this insidious syndrome could call for individual interventions by health professionals or more community-based prevention interventions. The creation of such a syndrome is part of a biopsychosocial approach which is familiar to the scientific activity of the University Institute of Mental Health of Montreal (IUSMM).

In 1909, 21-year-old Bernadette was hospitalized after the parish priest deemed her to be suffering from "puerperal insanity." She was committed to Saint-Jean-de-Dieu, separated from her newborn and husband, who would send dozens of letters inquiring about her health and longing for the day she could return home. Sadly, that return never happened. This article explores the evolution of psychiatric and mental health practices from the past to the present - and the progress still to be made - by focusing on alternatives to hospitalization. How might Bernadette's care have been managed today? And what could her care pathway look like 50 years from now? Today, the expertise of the Institut universitaire en santé mentale de Montréal (IUSMM) extends beyond its walls, reaching people in their own environments. Bernadette could have received treatment at home, supported by a care team with her husband playing an active role. This article documents current alternatives to hospitalization and links them to the lived experience of a woman who underwent involuntary hospitalization over a century after Bernadette. By examining three distinct eras, we can see not only how far we've come but also the challenges that remain.

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.