Guy Beauchamp

Influence of diagnostic classification on gender ratio in schizophrenia - a meta-analysis of youths hospitalized for psychosis.

BackgroundThe research literature on hospital admissions for psychoses in youths was reviewed in order to test whether there was a gender ratio discrepancy in diagnostic subgroups; the effect of the diagnostic criteria classification on this measure was also investigated.MethodA meta-analysis was conducted on 12 primary studies by assessing the male/female odds ratio (OR) in the schizophrenia and mood disorders with psychosis subgroups as well as the amount of variability between studies. Study inclusion criteria were: patients between the ages of 8 and 19, at least 15 patients with psychosis and a standardized diagnostic criteria classification system such as DSM, ICD or RDC.ResultsThe male/female OR measured in this meta-analysis implies that a male subject with psychosis is 1.7 times as likely to obtain a diagnosis of schizophrenia; conversely, a female subject with psychosis is 2.1 times as likely to be assigned in the mood disorders with psychosis subgroup. Disparity in diagnostic criteria nomenclature (ICD-9 vs. DSM) could account for a statistically significant difference in male/female OR for the schizophrenia subgroup in a subset of 11 studies.ConclusionsUnder the narrower definition of schizophrenia in studies using DSM diagnostic criteria classification, the shift towards a greater proportion of patients diagnosed with mood disorders with psychosis could be explained by the time criteria; the simultaneous emergence of the gender ratio difference is discussed. This study shows that subtle changes in diagnostic criteria in psychiatric illnesses can greatly influence observational data pertaining to youths.

Developmental model of suicide trajectories

BACKGROUND Most developmental studies on suicide do not take into account individual variations in suicide trajectories. AIMS Using a life course approach, this study explores developmental models of suicide trajectories. METHOD Two hundred and fourteen suicides were assessed with mixed methods. Statistical analysis using combined discrete-time survival (DTS) and growth mixture modelling (GMM) generated various trajectories, and path analysis (Mplus) identified exogenous and mediating variables associated with these trajectories. RESULTS Two groups share common risk factors, and independently of these major risk factors, they have different developmental trajectories: the first group experienced a high burden of adversity and died by suicide in their early 20s; and the second group experienced a somewhat moderate or low burden of adversity before they took their own life. Structural equation modelling identified variables specific to the early suicide trajectory: conduct and behavioural difficulties, social isolation/conflicts mediated by school-related difficulties, the end of a love relationship, and previous suicide attempts. CONCLUSIONS Psychosocial adversity between 10 and 20 years of age may warrant key periods of intervention.

Volume and social context of physical activity in association with mental health, anxiety and depression among youth.

There is growing interest in physical activity (PA) to prevent mental disorders in youth. However, few studies examine the association between PA and mental health. Further, how PA volume and context relate to mental health and mental disorders remains unclear, especially among youth in transition to adulthood. This study examined the cross-sectional associations among PA volume and context, mental health, and symptoms of anxiety and depression in post-secondary students. A total of 1527 post-secondary students (97.4% were age 16-24years) recruited in a CEGEP in Quebec, Canada completed a self-report questionnaire during class-time in October 2013. Multivariate linear regression was used to model the associations between PA volume and context and mental health, anxiety and depression controlling for sex, age and perceived socioeconomic status. Volume of moderate-to-vigorous leisure time PA (MVPA) was positively associated with mental health (β (95% CI)=0.072 (0.045, 0.099)) and inversely associated with symptoms of anxiety (-0.011 (-0.020, -0.001)) and depression (-0.010 (-0.017, -0.003)). Volume including all PA intensities was associated with mental health (0.052 (0.028, 0.076)). After controlling for PA volume, active youth involved in team sports had better mental health than those who engaged in PA individually. PA volume and the social context of PA are independently associated with mental health among youth. MVPA is inversely associated with anxiety and depressive symptoms.

Do male and female gamblers have the same burden of adversity over their life course

The objective of this research is to investigate gender difference and the burden of adversity during the life course of people who develop gambling problems. A sample of 86 adult participants met the criteria for at-risk problem gambling over the last 5 years. Data were obtained from informants during semi-structured face-to-face interviews, using SCID I and II, SOGS, Module K and a recount of life trajectories methodology. The results showed a high level of adversity throughout the life trajectories of the men and women studied. The results indicated that the major load of mental health disorders, the presence of anxiety disorders and co-morbid mental health disorders are more significant among women. Results also indicated a significant presence of violence in the lives of both men and women during early childhood and adolescence. During adulthood, women are more likely to be victims of intimate partner or marital violence whereas men tended to cumulate difficulties in social fields and especially in their professional lives. This significant burden of adversity creates a number of difficulties which makes it complicated to isolate gambling activities. Clinicians might have difficulty detecting female gamblers during consultation, especially when they present with co-morbid mental health disorders and violence issues.

Male gamblers – suicide victims and living controls: comparison of adversity over the life course

Abstract The objective of this research is to investigate the possible difference in accumulation of adversity over the life course among decedent gamblers and living control gamblers in the province of Quebec, Canada. A sample of 90 adult men, 41 living participants and 49 suicide decedents, met the criteria for at-risk and problem gambling over the last five years. Data were obtained from informants in the case of suicide and directly from living controls during semi-structured face-to-face interviews using SCID I and II, SOGS, Module K and a recount of life trajectories methodology. The results showed a high level of adversity throughout the life trajectories of both groups. However, the living gamblers faced more difficulties during their lifespan than the suicide victims. In the last six months before their death, suicide victims had a significantly higher number of mental health disorders, especially co-morbid mental health disorders and anxiety, compared to the living controls. We also observed a rapid escalation of difficulties, more life events and more psychological distress in the last six months of their lives among the suicide decedents. Suicidal behaviour needs to be carefully investigated by medical staff and mental health practitioners, especially when gamblers demonstrate evidence of mental health disorders or financial difficulties.

Temperament and Character Profiles of Group-Based Suicide Cases.

Background: Personality and character traits may be a key predisposing factor to consider in the life course of people who are vulnerable to suicide. Aims: The aim of this study is first to explore the possible presence of different subgroups of suicide decedents based on developmental profiles of adversity, and secondly to examine the association of personality and character dimensions (covariates) with the trajectory outcome. Method: A total of 90 cases of suicide decedents were analyzed using growth mixture modeling (GMM). Results: Results generated two different life trajectories and identified specific temperament profiles. Subjects assigned to the trajectory of high burden of adversity demonstrated a greater predisposition for harm avoidance and those in the trajectory characterized by low burden of adversity displayed greater predisposition for self-directedness. Conclusion: Our results add to the literature by suggesting that different subgroups of suicide completers show a predisposition for either harm avoidance or self-directedness.

Trajectories from Childhood to Suicide: The Role of Childhood Adversity and Psychopathology

Objective: With a life course perspective, we have identified the diverse pathways in which cumulative adversity in childhood and adolescence lead to detrimental outcomes: psychopathology and suicide. This studys design allowed us to address some major, controversial developmental issues surrounding the contribution of multiple forms of adversity (victimization events versus non-victimization events) to negative outcomes, specifically mental health disorders and suicide. Method: We combined three statistical analyses: discrete time survival (DTS), latent class growth analysis (LCGA) and path analysis to identify the sequence of events and conditions that contribute to the development of psychopathology and suicide. Results: Our results show that the process implicates early childhood adversities that act in a cascading manner and are cumulative in two ways: quantitatively and qualitatively. Therefore, pathways with more severe adverse experiences in childhood (victimization such as abuse or neglect) or with a greater number of adversity events (non-victimization) both tend to produce mental health problems and suicidal behavior early in life, contrary to pathways with fewer or less severe adversities.