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Dedovic K.,Douglas Hospital Research Center | Dedovic K.,University of California at Los Angeles | Ngiam J.,McGill University
Neuropsychiatric Disease and Treatment | Year: 2015

A vast body of literature has revealed that dysregulation of the hypothalamic–pituitary–adrenal (HPA) stress axis is associated with etiology of major depressive disorder (MDD). There are many ways that the dysregulation of the HPA axis can be assessed: by sampling diurnal basal secretion and/or in response to a stress task, pharmacological challenge, and awakening. Here, we focus on the association between cortisol awakening response (CAR), as one index of HPA axis function, and MDD, given that the nature of this association is particularly unclear. Indeed, in the following selective review, we attempt to reconcile sometimes-divergent evidence of the role of CAR in the pathway to depression. We first examine association of CAR with psychological factors that have been linked with increased vulnerability to develop depression. Then, we summarize the findings regarding the CAR profile in those with current depression, and evaluate evidence for the role of CAR following depression resolution and continued vulnerability. Finally, we showcase longitudinal studies showing the role of CAR in predicting depression onset and recurrence. Overall, the studies reveal an important, but complex, association between CAR and vulnerability to depression. © 2015 Dedovic and Ngiam.

Fleury M.J.,Douglas Hospital Research Center
Global journal of health science | Year: 2012

The study was designed to identify factors associated with the diversity of professionals consulted by 212 individuals affected by at least one mental disorder in the past 12 months in a Montreal catchment area. For inclusion in the study, participants had to be aged 15 to 65 and reside in the study zone. A comprehensive set of variables were analyzed in accordance with the Andersen's behavioural model of health service use. General practitioners, psychiatrists, and psychologists were the main professionals consulted in this study. Having post-secondary education, more than a single mental disorder, excellent relationships with neighbours, and (marginally) being a lifelong victim of violence were associated with higher numbers of professionals consulted. As this study highlights the large number of diversified professionals consulted for reason of mental disorders, shared care initiatives may prove beneficial. Greater effort could also be made in increasing services toward those deemed more vulnerable.

Caron J.,McGill University | Caron J.,Douglas Hospital Research Center | Liu A.,McGill University
Community Mental Health Journal | Year: 2011

This study presents a comparison of the level of psychological distress between low-income and non low-income populations in Canada. It describes the factors associate with distress identified for each population and presents the differences found with the models used in predicting distress. Data were collected through the Canadian Community Health Survey, Cycle 1.2 including 36,984 individuals aged 15 or over. Of this sample, 17.9% (N = 7,940) was identified as being within the lowincome population. In the low-income population, the percentage of high psychological distress was as high as 28%, compared to 19% in the non low-income population. Variables related to social support, stress and coping abilities were the stronger sets of variables related to distress in both populations. The results provided evidence that although economically disadvantaged and more affluent populations share many variables associated with psychological distress, they have a different profile on the correlates of psychological distress. © Springer Science+Business Media, LLC 2010.

Kebir O.,University of Paris Descartes | Joober R.,McGill University | Joober R.,Douglas Hospital Research Center
European Archives of Psychiatry and Clinical Neuroscience | Year: 2011

As a relatively large body of research has been published up to now, it may be informative to explore whether the use of endophenotypes has produced consistent findings in attention-deficit hyperactivity disorder (ADHD). We reviewed the results of genetic studies investigating associations between putative susceptibility genes for ADHD and neuropsychological traits relevant for this disorder. A PubMed database search identified 47 studies. Most of them (n = 36) examined a single candidate gene, while seven studies examined two or three genes and only four studies examined 10 genes or more. The most investigated genes were DRD4, DAT1, COMT, MAOA, and DBH. Regarding DRD4, association of high reaction time variability with the 7-R allele absence appears to be the most consistent result. Speed of processing, set shifting, and cognitive impulsiveness were less frequently investigated, but seem to be altered in the 7-R allele carriers. Regarding DAT1, majority of studies reported negative results indicating that this gene may have a modulating effect rather than direct influence on cognitive functioning. The other genes were investigated in fewer studies, and the reported findings need to be replicated. The principal methodological issues that could represent confounding factors and may explain conflicting results are discussed. © 2011 Springer-Verlag.

Caron J.,McGill University | Caron J.,Douglas Hospital Research Center
Social Indicators Research | Year: 2012

Most epidemiological studies agree that economically disadvantaged populations are the groups most vulnerable to mental health problems and report lower quality of life among these populations. However, it appears that access to social support plays a role in protecting against the chronic stress resulting from conditions such as poverty. This study is an attempt to clarify the relative contribution of social support to the quality of life of economically disadvantaged populations in two low-income neighbourhoods of Montreal. A random sample of 417 social assistance recipients were interviewed in the respondents' homes. The Quality of Life scale used was the Satisfaction with Life Domains Scale. The availability of social support components was assessed using the Social Provisions Scale. Social support measures were entered into a multidimensional model that included a number of variables identified as having a relationship to mental health. Among the 17 variables included in a multiple regression analysis, emotional support and support providing reassurance of worth accounted for most of the variance in the QOL predicted by the model. Psychological distress also accounted for a fair amount of variance in QOL and younger people and people experiencing food insecurity showed a lower QOL. © 2011 Springer Science+Business Media B.V.

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