Improving adherence to physical activity in treatment-resistant depression: Protocol for a pilot randomized controlled trial of a remotely delivered program.

Background: At least 30% of individuals with major depressive disorder do not respond to conventional treatments (i.e., they meet the criteria for treatment-resistant depression [TRD]).

Measurement-Based Care to Enhance Antidepressant Treatment Outcomes in Major Depressive Disorder: A Randomized Clinical Trial.

Importance: Measurement-based care (MBC) guides clinical decisions through structured monitoring of symptoms and adverse effects. Although MBC has been associated with improved outcomes in major depressive disorder (MDD), its effectiveness in low- and middle-income countries (LMICs) remains understudied.

Objective: To assess whether MBC accelerates the resolution of depressive symptoms compared with standard care among adults with MDD in Pakistan.

Sociodemographic and clinical characteristics among individuals with bipolar disorder in Pakistan - a gender-focused analysis.

Background: Bipolar disorder (BD) is a relapsing and remitting mental disorder affecting over 40 million people worldwide, with a substantial burden in low- and middle-income countries (LMICs). There is limited knowledge on BD in Pakistan. Understanding sociodemographic and clinical characteristics of BD is needed for developing culturally and contextually relevant interventions.

The impact of lifetime excessive alcohol use on behavioural and psychological symptoms of dementia.

Introduction: Excessive alcohol use (EAU) elevates the risk of dementia through various mechanisms, yet its impact on the behavioural and psychological symptoms of dementia (BPSDs) remains uncertain.

Methods: In this exploratory cross-sectional analysis of baseline data from the Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov/NCT03672201), we included individuals with Alzheimer's disease and related dementias requiring BPSD treatment.

Home-based cognitive remediation and transcranial direct current stimulation to enhance cognition in older adults with major depressive disorder or mild cognitive impairment: An open label study.

Objectives: Interventions to prevent dementia among older adults with high-risk conditions such as Mild Cognitive Impairment (MCI) or Major Depressive Disorder (MDD) are highly needed. This study assessed the feasibility, adherence, safety, and clinical effects of home-based Cognitive Remediation (CR) with transcranial Direct Current Stimulation (tDCS) delivered by study partners in these populations.

Design: Open-label study.

Analysis of Demographic and Practice Characteristics of Psychiatrists in Three Canadian Provinces: Analyse des caractéristiques démographiques et de la pratique des psychiatres dans trois provinces canadiennes.

Objective: To describe demographic and practice characteristics of psychiatrists in British Columbia (BC), Manitoba (MB) and Ontario (ON) and explore how practice characteristics change by psychiatrist sex/gender and years since medical school graduation.

Method: We conducted a repeated cross-sectional study of all practising psychiatrists who had patient interactions and submitted billings from the fiscal years (FY) 2012/2013 to 2021/2022 using linked administrative data in BC, MB and ON. Psychiatrist demographic variables included age, sex/gender, years since medical school graduation and their practice location.

Mapping psilocybin therapy: A systematic review of therapeutic frameworks, adaptations, and standardization across contemporary clinical trials.

Accumulating evidence suggests that psilocybin can produce rapid and sustained clinical benefits when administered in conjunction with psychological support. Though non-pharmacological procedures are considered integral, the field lacks therapeutic guidelines and little is known about current practices. This systematic review sought to provide a comprehensive and cross-diagnostic synthesis of current psilocybin therapy (PT) protocols across contemporary mental health related trials.

Neuropsychiatric Symptoms Present Differently in Individuals with Different High-Risk States of Dementia.

Introduction: Neuropsychiatric symptoms (NPS) are common in neurocognitive disorders. However, the differences in presentation of NPS in high-risk states for dementia such as mild neurocognitive disorder (Mild NCD) and remitted major depressive disorder (rMDD) remain unclear. The purpose of this study was to compare the frequency and factor structure of NPS in Mild NCD, rMDD, and Mild NCD with rMDD (Mild NCD-rMDD).

Evolution of Electroconvulsive Therapy Practice During the COVID-19 Pandemic: A Systematic Review.

The COVID-19 pandemic disrupted the provision of electroconvulsive therapy (ECT) across the globe, challenging ECT services to develop protocols that preserve access to this life-saving treatment. This systematic review maps the literature on global ECT practice during the COVID-19 pandemic. The English-language literature was searched through OVID (MEDLINE, PsycINFO, and Embase) on August 7, 2024.

A Multi-Site, Randomized, Parallel-Group, Controlled Trial of Virtually-Delivered Sahaj Samadhi Meditation for the Management of Moderate Depressive Symptoms in Chronic Pain.

Background: Chronic pain (CP) often co-occurs with depression, but promising scalable interventions have been under-investigated. We assessed the effectiveness of the virtually-delivered Sahaj Samadhi Meditation (SSM) program in reducing depressive symptoms in people with CP and moderate depressive symptoms.

Methods: We conducted a randomized controlled trial comparing SSM to the Health Enhancement Program (HEP), an active control.

Moderators of antidepressant augmentation versus switch in the OPTIMUM randomised controlled trial.

Background: Older adults with treatment-resistant depression (TRD) benefit more from treatment augmentation than switching. It is useful to identify moderators that influence these treatment strategies for personalised medicine.

Aims: Our objective was to test whether age, executive dysfunction, comorbid medical burden, comorbid anxiety or the number of previous adequate antidepressant trials could moderate the superiority of augmentation over switching.

Brain-cognition relationships and treatment outcome in treatment-resistant late-life depression.

Older adults with treatment-resistant depression are at significant risk for cognitive impairment. The relationship between treatment response and cognitive function in this population is not well-established. We examined neural correlates of executive and memory function, and their relationship with prospective treatment outcomes.

Assessing Motor Cortex Excitability and Its Relationship with Cortical Atrophy in Alzheimer's Dementia.

Background: Cortical excitability has been proposed as a novel neurophysiological marker of neurodegeneration in Alzheimer's dementia (AD). However, the link between cortical excitability and structural changes in AD is not well understood.

Objective: To assess the relationship between cortical excitability and motor cortex thickness in AD.

A Longitudinal Study of the Relationship Among Cognition, Mood Symptoms, and Markers of Brain Health in Older Age Bipolar Disorder: Une étude longitudinale de la relation entre la cognition, les symptômes thymiques, et les marqueurs de la santé du cerveau en présence de troubles bipolaires du sujet âgé.

Objectives: An emerging literature has assessed cognition or imaging markers of brain health in in older age bipolar disorder (OABD). In this context, we conducted the first longitudinal study (to our knowledge) that assessed the relationship among cognition, mood symptoms, and imaging markers of brain health in OABD.

Methods: 99 participants with OABD were enrolled, underwent baseline assessment, and were followed annually for up to 3 years.

Relationship of the revised anticholinergic drug scale with cultured cell-based serum anticholinergic activity and cognitive measures in older adults with mild cognitive impairment or remitted depression.

Objective: The Anticholinergic Drug Scale (ADS) is a commonly used measure of anticholinergic exposure. This study describes an expanded and revised version of the ADS (rADS) and its relationship with cultured cell-based serum anticholinergic activity (cSAA) and cognitive measures.

Study Participants: Adults aged 60 years and older with mild cognitive impairment (MCI), remitted major depressive disorder (rMDD), or both, participate in the Prevention of Alzheimer's Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study.

Blood Angiogenesis Markers and Cognition in Older Adults at Risk for Dementia: Marqueurs sanguins de l'angiogenèse et cognition chez les personnes âgées à risque de démence.

ObjectiveChanges in angiogenesis have been shown to contribute to cognitive decline and dementia. We aimed to identify angiogenesis blood markers associated with cognitive performance in older adults with mild cognitive impairment (MCI), remitted major depressive disorder (rMDD), or both (rMDD + MCI) who are at risk for dementia.MethodWe analyzed data from participants with MCI, rMDD, or rMDD + MCI in the Prevention of Alzheimer's Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression study.

Associations between structural brain measures and cognitive function in bipolar disorder: a systematic review and meta-analysis.

Bipolar disorder (BD) is a chronic condition characterized by recurrent mood episodes and persistent cognitive deficits that span multiple domains, ultimately impacting daily functioning. Understanding the neural underpinnings of these impairments is crucial. In a systematic review and meta-analysis examining 80 studies (with 50 meeting criteria for meta-analysis) of adults with BD, relationships between structural brain measures and cognitive performance were evaluated.

Prediction of remission of pharmacologically treated psychotic depression: A machine learning approach.

Background: The combination of antidepressant and antipsychotic medication is an effective treatment for major depressive disorder with psychotic features ('psychotic depression'). The present study aims to identify sociodemographic and clinical predictors of remission of psychotic depression treated with combination pharmacotherapy and determine the accuracy of prediction models.

Methods: Two hundred and sixty-nine participants aged 18 to 85 years with psychotic depression were acutely treated with protocolized sertraline plus olanzapine for up to 12 weeks.

Day-to-day variability in activity levels detects transitions to depressive symptoms in bipolar disorder earlier than changes in sleep and mood.

Anticipating clinical transitions in bipolar disorder (BD) is essential for the development of clinically actionable predictions. Our aim was to determine what is the earliest indicator of the onset of depressive symptoms in BD. We hypothesized that changes in activity would be the earliest indicator of future depressive symptoms.

Regional Variation in Supply and Use of Psychiatric Services in 3 Canadian Provinces: Variation régionale de l'offre de services psychiatriques et de leur utilisation dans trois provinces canadiennes.

ObjectiveTo examine the patterns in the supply and use of psychiatric services in 3 Canadian provinces: British Columbia, Manitoba, and Ontario.MethodsWe conducted a repeated cross-sectional analysis spanning fiscal years 2012/13 to 2021/22, using patient- and psychiatrist-level data aggregated into administrative health regions. Descriptive statistics and linear regression were used to assess patterns and relationships between the per capita number of psychiatrists ("supply") and measures of use of psychiatric services ("utilization"), including any psychiatrist contact, psychiatric consultation (1-2 visits with the same psychiatrist), and ongoing psychiatric care (3 or more visits with the same psychiatrist).

Personalising Antidepressant Treatment for Unipolar Depression Combining Individual Choices, Risks and big Data: The PETRUSHKA Tool: Personnalisation du traitement antidépresseur de la dépression unipolaire associant choix individuels, risques et mégadonnées: l'outil PETRUSHKA.

ObjectiveWe summarize the key steps to develop and assess an innovative online, evidence-based tool that supports shared decision-making in routine care to personalize antidepressant treatment in adults with depression. This PETRUSHKA tool is part of the PETRUSHKA trial (Personalize antidEpressant Treatment foR Unipolar depreSsion combining individual cHoices, risKs, and big datA).MethodsThe PETRUSHKA tool: (a) is based on prediction models, which use a combination of advanced analytics, i.

Task-sharing and telemedicine delivery of psychotherapy to treat perinatal depression: a pragmatic, noninferiority randomized trial.

Task-sharing and telemedicine can increase access to effective psychotherapies. Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) is pragmatic, multisite, noninferiority, four-arm trial that tested the non-inferiority of provider (non-specialist vs. specialist providers) and modality (telemedicine vs.

Challenges Related to the Implementation of Measurement-Based Care for the Treatment of Major Depressive Disorder: A Feasibility Study.

Measurement-based care (MBC) involves systematically assessing patients' symptoms and adverse events using standardized scales to guide treatment. While MBC has been shown to enhance the quality of care and outcomes in the pharmacotherapy of major depressive disorder (MDD), it is still rarely used in clinical practice. In this study, the feasibility of implementing MBC was assessed for patients with MDD seen in a large outpatient psychiatry clinic.

Cognitive Outcomes After Transcranial Magnetic Stimulation for the Treatment of Late-Life Depression: Résultats cognitifs après la stimulation magnétique transcrânienne pour le traitement de la dépression chez les personnes âgées.

Background: Late-life depression (LLD) is often accompanied by cognitive impairment, which may persist despite antidepressant treatment. Repetitive transcranial magnetic stimulation (rTMS) is an efficacious treatment for depression, with potential benefits on cognitive functioning. However, research on cognitive effects is inconclusive, relatively sparse in LLD, and predominantly focused on group-level cognitive changes.