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Objectives: To characterize health related quality of life (HRQOL) for Canadians aged 16 to 25 (adolescents and young adults, AYAs) seeking care for mood and anxiety concerns at the First Episode Mood and Anxiety Program, in London, Ontario and to identify factors associated with HRQOL in this population. Methods: AYAs completed demographic, psychometric, and HRQOL questionnaires. We calculated 36-Item Short-Form Health Survey (SF-36) scores standardized to Canadian and US population norms. We computed Short Form 6 Dimension (SF-6D) utilities conducting multivariable linear regression analysis, adjusting for age, sex, ethnoracial minority status, parental marital/cohabitation status, parental education, the Anxiety Sensitivity Index (ASI-R), Montgomery-Åsberg Depression Rating Scale Self-Report (MADRS-S), Sheehan Disability Scale (SDS), and a modified Inventory of College Students' Recent Life Experiences (ICSRLE-M). Results: Amongst 182 AYAs who completed questionnaires, mean physical component summary (PCS), mental component summary (MCS) and SF-6D utility scores were low, 43.8 (SD = 16.6), 19.0 (SD = 11.9) and.576 (SD =.074), respectively. Maternal post-secondary education, depression (MADRS-S) and functional impairment (SDS) were significantly associated with SF-6D utility. Conclusion: This cohort of mental healthcare-seeking AYAs had significantly impaired psychometric and utility-based measures of quality of life, underscoring the importance of timely access to healthcare services for this population. [ABSTRACT FROM AUTHOR]

Introduction Recent research has suggested that, in the absence of heavy processing demands, activity in the brain is characterized by positively correlated, low-frequency (> 0.1 Hz) oscillations within functional neural [...], Background: The 'default network' consists of a number of brain regions that exhibit correlated low-frequency activity at rest and that have been suggested to be involved in the processing of self-relevant stimuli. Activity in many of these areas has also been shown to be altered in individuals with posttraumatic stress disorder (PTSD). We hypothesized that the posterior cingulate cortex (PCC)/precuneus, part of the default network, would exhibit altered connectivity at rest with other areas of the default network and regions associated with PTSD. Methods: Seventeen medicated and unmedicated female patients with chronic posttraumatic stress disorder (PTSD) related to early-life trauma and 15 healthy female controls underwent a 5.5-minute functional magnetic resonance imaging scan with their eyes closed. We assessed areas of the brain whose activity positively and negatively correlated with that of the PCC/precuneus in both groups. Results: At rest, spontaneous low-frequency activity in the PCC/precuneus was more strongly correlated with activity in other areas of the default network in healthy controls than in patients with PTSD. Direct comparison of the 2 groups showed that PCC/ precuneus connectivity was also greater in healthy controls than in patients with PTSD in a number of areas previously associated with PTSD, including the right amygdala and the hippocampus/parahippocampal gyrus. Limitations: Because our PTSD sample comprised only women with chronic early-life trauma exposure, our results may not be generalizeable to male patients, to a population with single trauma exposure or to those who were adults when the trauma occurred. In addition, our sample included patients taking medication and it is not yet clear how altered connectivity is affected by medication. Conclusion: Spontaneous activity in the default network during rest, as measured using PCC correlations, is altered in patients with PTSD. The potential effects of psychotropic medications on default network connectivity in the present sample remain unknown. In this patient population, the observed alterations may be associated with the disturbances in self-referential processing often observed in patients with chronic PTSD related to early-life trauma. Contexte : Le <> englobe plusieurs regions du cerveau qui manifestent une activite de basse frequence correlee au repos et qui, comme le suggerent certains, joueraient un role dans le traitement des stimuli autoreferentiels. Dans bon nombre de ces regions, l'activite s'est egalement revelee perturbee chez les individus atteints de syndrome de stress post-traumatique (SSPT). Selon notre hypothese, le cortex cingulaire posterieur (CCP) et le precuneus, elements du reseau par defaut, manifesteraient au repos une connectivite alteree avec les autres regions du reseau par defaut et les regions associees au SSPT. Methodes : Dix-sept patientes (dont certaines traitees pharmacologiquement) atteintes d'un syndrome de stress post-traumatique chronique lie a un traumatisme subi en bas age, de meme que 15 participantes temoins en bonne sante, ont subi une epreuve d'imagerie par resonance magnetique fonctionnelle de 5,5 minutes, les yeux fermes. Nous avons examine les regions du cerveau dont l'activite etait en correlation positive et negative avec le CCP/precuneus dans les 2 groupes. Resultats : Au repos, l'activite de basse frequence spontanee du CCP/precuneus a ete en plus forte correlation avec celle des autres regions du reseau par defaut chez les temoins en bonne sante que chez les patientes atteintes de SSPT. Une comparaison directe entre les 2 groupes a revele que la connectivite CCP/precuneus etait egalement plus grande chez les temoins en bonne sante que chez les patientes atteintes de SSPT dans un certain nombre de regions auparavant associees avec le SSPT, y compris l'amygdale cerebrale droite et la region hippocampe/gyrus parahippocampique. Limites : Etant donne que notre echantillon de patientes atteintes de SSPT ne comprenait que des femmes presentant un syndrome chronique consecutif a un traumatisme subi en bas age, nos resultats pourraient ne pas s'appliquer aux hommes, aux victimes de traumatismes simples ou aux patients qui etaient adultes lors du traumatisme. De plus, notre echantillon incluait des patientes qui prenaient des medicaments; or, l'impact potentiel de ceux-ci sur la connectivite est inconnu. Conclusion : L'activite spontanee du reseau par defaut au repos, mesuree par l'analyse de ses correlations avec le CCP, est alteree chez des patientes atteintes de SSPT. Les effets potentiels des psychotropes sur la connectivite du reseau par defaut dans le present echantillon demeurent inconnus. Chez cette population de patients, les alterations observees peuvent etre associees a des dereglements du traitement des stimuli autoreferentiels souvent observes chez les patients atteints de SSPT chronique consecutif a un traumatisme subi en bas age.

Stress, especially the extreme stress of traumatic events, can alter both neurobiology and behavior. Such extreme environmental situations provide a useful model for understanding environmental influences on human biology and behavior. This paper will review some of the evidence of brain alterations that occur with exposure to environmental stress. This will include recent studies using neuroimaging and will address the need for histological confirmation of imaging study results. We will review the current scientific approaches to understanding brain environment interactions, and then make the case for the collection and study of postmortem brain tissue for the advancement of our understanding of the effects of environment on the brain. Creating a brain tissue collection specifically for the investigation of the effects of extreme environmental stressors fills a gap in the current research; it will provide another of the important pieces to the puzzle that constitutes the scientific investigation of negative effects of environmental exposures. Such a resource will facilitate new discoveries related to the psychiatric illnesses of acute stress disorder and posttraumatic stress disorder, and can enable scientists to correlate structural and functional imaging findings with tissue abnormalities, which is essential to validate the results of recent imaging studies.

Nonsuicidal self-injurious behavior (SIB) occurs in both culturally appropriate and culturally inappropriate forms. It is one of the diagnostic criteria for borderline personality disorder, but it occurs in several psychiatric and neurological populations. The personal intent of SIB in psychiatric populations is incompletely understood. A self-report scale (Self-Injury Motivation Scale; SIMS) to assess motivation for self-injury was developed. Relationships among motivation for SIB, characteristics of SIB, and psychopathology were explored. A semistructured interview and the SIMS, Dissociative Experiences Scale, Beck Depression Inventory, Davidson Trauma Scale, and Millon Clinical Multiaxial Inventory-II were given to 99 consecutively admitted inpatients. The SIMS had good reliability and validity. A high SIMS score suggested distinct psychopathology. Several factors on the SIMS differentiated motivations for SIB. Patients with different SIMS factor profiles had different psychopathology.

Active patients at The First Episode Mood and Anxiety Program (FEMAP) were asked to participate in a study monitoring their symptoms during early COVID-19 closures. Participants were asked to predict both possible positive and feared outcomes of the pandemic. Responses were analyzed with a descriptive qualitative approach using thematic analysis. Primary feared outcomes included death, prolonged pandemic impacts, and concerns about employment, mental health, and education. Prevalent positive predictions included a new perspective, improved relationships, personal growth, and environmental improvement. These findings suggest the complex relationship between fear and hope for young people in the early stages of the pandemic. [ABSTRACT FROM AUTHOR]

Aim: The COVID‐19 quarantine closed many mental health services. Emerging adults with pre‐existing mood or anxiety disorders were of concern for worsening symptoms. We sought to demonstrate a method for monitoring mental health status of a group of patients with reduced access to their usual mental health services during quarantine. Methods: A total of 326 patients enrolled in the First‐Episode Mood and Anxiety Program in London, Ontario, Canada were invited to participate in online questionnaires regularly. Patients were flagged for high level of risk based on depression scores, suicidal ideation and worsening in anxiety, depression or quality of health. All patients were also asked if they wanted contact with a clinician. Results: One hundred and fourteen (35%) patients completed at least one questionnaire. Thirty were flagged based on scores; 37 (32.5%) participating patients requested help. Participants who were flagged for concerning scores were younger, more likely to be on the wait list for treatment, to have been laid off from work and have more functional impairment. Participants requesting support had higher symptom scores for depression and lower scores on quality of health. Conclusions: The process utilized here identified patients at risk and in need of clinical support in the context of pandemic quarantine. It provided an accessible avenue for invited patients to communicate both symptom status and need for contact. Such a process can provide valuable monitoring during times when the usual communications between patients and health care providers is compromised and clinician time is limited. It is easily implemented. [ABSTRACT FROM AUTHOR]

Aim: The First Episode Mood and Anxiety Program (FEMAP) is a community‐based early intervention program that has been shown to improve health outcomes for emerging adults (EAs) with mood and anxiety disorders. However, not all EAs who are admitted to the program initiate treatment. Our aim was to identify factors that distinguish those who initiated treatment from those who did not. Methods: FEMAP administered questionnaires to EAs upon first contact with the program, collecting information on a range of socioeconomic, patient and condition‐related factors. We compared EAs who initiated treatment in the program (n = 318, 87.4%) to those who did not (n = 46, 12.6%). To examine factors associated with treatment initiation, we specified a parsimonious logistic regression model, using the method of purposeful selection to choose from a range of candidate variables. Results: Anxiety Sensitivity Index ‐ Revised (ASI‐R), binge drinking and cannabis use were included in the final logistic regression model. Each one‐point increment in the ASI‐R score was associated with a 1% increase in the odds of treatment initiation (OR = 1.014; 95% CI [1.003, 1.026]). No other variable was significantly associated with treatment initiation. Conclusions: Our study provides insight on the differences between EAs with mood and anxiety disorders who initiated targeted treatment services and those who did not. Anxiety sensitivity was significantly associated with treatment initiation at FEMAP. Our findings suggest that it may be anxiety sensitivity, rather than depression or functional impairment per se that drive treatment initiation among EAs. [ABSTRACT FROM AUTHOR]