Douglas Hospital Research Center

Verdun, Canada

Douglas Hospital Research Center

Verdun, Canada

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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.


King S.,Douglas Hospital Research Center | King S.,McGill University | Dancause K.,Douglas Hospital Research Center | Dancause K.,McGill University | And 4 more authors.
Birth Defects Research Part C - Embryo Today: Reviews | Year: 2012

Research on the developmental origins of health and disease highlights the plasticity of the human fetus to a host of potential teratogens. Experimental research on laboratory animals has demonstrated a variety of physical and behavioral effects among offspring exposed to prenatal maternal stress (PNMS). However, these studies cannot elucidate the relative effects of the objective stress exposure and the subjective distress in a way that would parallel the stress experience in humans. PNMS research with humans is also limited because there are ethical challenges to designing studies that involve the random assignment of pregnant women to varying levels of independent stressors. Natural disasters present opportunities for natural experiments of the effects of pregnant women's exposure to stress on child development. In this review, we present an overview of the human and animal research on PNMS, and highlight the results of Project Ice Storm which has been following the cognitive, behavioral, motor and physical development of children exposed in utero to the January 1998 Quebec Ice Storm. We have found that both objective degree of exposure to the storm and the mothers' subjective distress have strong and persistent effects on child development, and that these effects are often moderated by the timing of the ice storm in pregnancy and by the child's sex. © 2013 Wiley Periodicals, Inc.


Fleury M.-J.,McGill University | Fleury M.-J.,Douglas Hospital Research Center | Grenier G.,Douglas Hospital Research Center | Bamvita J.-M.,Douglas Hospital Research Center | Caron J.,McGill University
BMC Health Services Research | Year: 2014

Background: This study has a dual purpose: 1) identify determinants of healthcare service utilization for mental health reasons (MHR) in a Canadian (Montreal) catchment area; 2) determine the patterns of recourse to healthcare professionals in terms of frequency of visits and type of professionals consulted, and as it relates to the most prevalent mental disorders (MD) and psychological distress. Methods. Data was collected from a random sample of 1,823 individuals interviewed after a two-year follow-up period. A regression analysis was performed to identify variables associated with service utilization and complementary analyses were carried out to better understand participants' patterns of healthcare service utilization in relation to the most prevalent MD. Results: Among 243 individuals diagnosed with a MD in the 12 months preceding an interview, 113 (46.5%) reported having used healthcare services for MHR. Determinants of service utilization were emotional and legal problems, number of MD, higher personal income, lower quality of life, inability of individuals to influence events occurring in their neighborhood, female gender and, marginally, lack of alcohol dependence in the past 12 months. Emotional problems were the most significant determinant of healthcare service utilization. Frequent visits with healthcare professionals were more likely associated with major depression and number of MD with or without dependence to alcohol or drugs. People suffering from major depression, psychological distress and social phobia were more likely to consult different professionals, while individuals with panic disorders relied on their family physician only. Concerning social phobia, panic disorders and psychological distress, more frequent visits with professionals did not translate into involvement of a higher number of professionals or vice-versa. Conclusions: This study demonstrates the impact of emotional problems, neighborhood characteristics and legal problems in healthcare service utilization for MHR. Interventions based on inter-professional collaboration could be prioritized to increase the ability of healthcare services to take care especially of individuals suffering from social phobia, panic disorders and psychological distress. Others actions that could be prioritized are training of family physicians in the treatment of MD, use of psychiatric consultants, internet outreach, and reimbursement of psychological consultations for individuals with low income. © 2014 Fleury et al.; licensee BioMed Central Ltd.


Laplante D.P.,Douglas Hospital Research Center | Brunet A.,Douglas Hospital Research Center | Brunet A.,McGill University | King S.,Douglas Hospital Research Center | King S.,McGill University
Pediatric Research | Year: 2016

Background:To determine whether disaster-related prenatal maternal stress and maternal illness during pregnancy predict maternal-rated temperament status in 6-mo-old infants.Method:The temperamental status of 121 infants (60 boys and 61 girls) exposed in utero to varying degrees of maternal stress and/or illness during either first (n = 40), second (n = 43), or third (n = 38) trimester of pregnancy was assessed using the Infant Characteristics Questionnaire.Results:Higher levels of maternal subjective distress and illness were primarily independently associated with poorer temperamental status in the infants. Maternal subjective distress explained 3.4, 3.1, and 9.8% and early pregnancy illness explained 4.3, 5.8, and 2.9% of the variance of the infants' fussy/difficult, dullness, and needs attention temperament dimensions, respectively.Conclusion:This is the first study to assess whether temperament status is influenced by disaster-related prenatal maternal stress. Moreover, this is the first study to assess whether maternal stress and illness during pregnancy interact to determine infant temperament status. The findings suggest that while both factors predict temperament status at 6 mo, they do so primarily in an independent manner. These results suggest that pathways through which maternal stress and illness during pregnancy influence temperament status differ. © 2016 International Pediatric Research Foundation, Inc.


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.


Charil A.,McGill University | Charil A.,Douglas Hospital Research Center | Laplante D.P.,Douglas Hospital Research Center | Vaillancourt C.,University of Québec | And 2 more authors.
Brain Research Reviews | Year: 2010

Prenatal stress (PS) has been linked to abnormal cognitive, behavioral and psychosocial outcomes in both animals and humans. Animal studies have clearly demonstrated PS effects on the offspring's brain, however, while it has been speculated that PS most likely affects the brains of exposed human fetuses as well, no study has to date examined this possibility prospectively using an independent stressor (i.e., a stressful event that the pregnant woman has no control over, such as a natural disaster). The aim of this review is to summarize the existing animal literature by focusing on specific brain regions that have been shown to be affected by PS both macroscopically and microscopically. These regions include the hippocampus, amygdala, corpus callosum, anterior commissure, cerebral cortex, cerebellum and hypothalamus. We first discuss the mechanisms by which the effects of PS might occur. In particular, we show that maternal and fetal hypothalamic-pituitary-adrenal (HPA) axes, and the placenta, are the most likely candidates for these mechanisms. We see that, although animal studies have obvious advantages over human studies, the integration of findings in animals and the transfer of these findings to human populations remains a complex issue. Finally, we show how it is possible to circumvent these challenges by studying the effects of PS on brain development directly in humans, by taking advantage of natural or man-made disasters and assessing the impact and consequences of such stressful events on pregnant women and their offspring prospectively. © 2010 Elsevier B.V.


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.


Cao-Lei L.,McGill University | Massart R.,McGill University | Suderman M.J.,McGill University | Machnes Z.,McGill University | And 4 more authors.
PLoS ONE | Year: 2014

Background: Prenatal maternal stress (PNMS) predicts a wide variety of behavioral and physical outcomes in the offspring. Although epigenetic processes may be responsible for PNMS effects, human research is hampered by the lack of experimental methods that parallel controlled animal studies. Disasters, however, provide natural experiments that can provide models of prenatal stress.Methods: Five months after the 1998 Quebec ice storm we recruited women who had been pregnant during the disaster and assessed their degrees of objective hardship and subjective distress. Thirteen years later, we investigated DNA methylation profiling in T cells obtained from 36 of the children, and compared selected results with those from saliva samples obtained from the same children at age 8.Results: Prenatal maternal objective hardship was correlated with DNA methylation levels in 1675 CGs affiliated with 957 genes predominantly related to immune function; maternal subjective distress was uncorrelated. DNA methylation changes in SCG5 and LTA, both highly correlated with maternal objective stress, were comparable in T cells, peripheral blood mononuclear cells (PBMCs) and saliva cells.Conclusions: These data provide first evidence in humans supporting the conclusion that PNMS results in a lasting, broad, and functionally organized DNA methylation signature in several tissues in offspring. By using a natural disaster model, we can infer that the epigenetic effects found in Project Ice Storm are due to objective levels of hardship experienced by the pregnant woman rather than to her level of sustained distress. © 2014 PLOS ONE.


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.

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