Browsing by Author "MacQueen, Glenda"
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- ItemOpen AccessA randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of developing major depression: a research protocol(2019-09-18) Wang, JianLi; MacQueen, Glenda; Patten, Scott; Manuel, Douglas; Lashewicz, Bonnie; Schmitz, NorbertAbstract Background Major depressive disorder is one of the most prevalent and disabling forms of mental illness in the general population. One public health strategy that may reduce the disease burden is early identification and prevention - identifying people who are at high risk and intervening to prevent symptoms from progressing into a major depressive episode (MDE). Multivariable risk predictive algorithms (MVRP) have been developed to estimate personalized risk (probability) of an MDE. The purpose of this trial is to answer the questions: (1) Does disclosure of personalized depression risk information promote high-risk individuals to take preventive actions? (2) Will disclosure of personalized depression risk information negatively affect the mental health of those at high risk? Methods We are recruiting 350 high-risk men and 350 high-risk women across the country. Individuals are eligible, if they: (1) are 18 years or older, (2) have not had a depressive episode in the past two months, (3) are at high risk of MDE based on the MVRPs (predicted risk of 6.5% + for men and of 11.2% + for women), (4) can communicate in either English or French, and (5) agree to be contacted for follow-up interviews. The MVRPs were developed and validated using longitudinal data from over 10,000 Canadians across the country. Eligible participants are randomized into (1) the control group, and (2) the group receiving personalized depression risk information. The participants are assessed at baseline, 6 and 12 months regarding accuracy of risk perception, use of self-help strategies and changes in psychological distress and functioning. Qualitative interviews are conducted in sub-samples of the intervention groups to explore how the personalized information affects risk perception, self-help behaviors and mental health. Discussion MVRPs can be used for risk stratification and planning preventive actions. The personalized risk information produced by MVRPs may also empower users to actively engage in self-management. This trial will contribute to the knowledge base about the potential health benefits and psychological harms associated with the provision of personalized depression risk information that will inform future implementation and patient-physician communication in the clinical settings. Trial registration NCT02943876 . Date of trial registration: October 21st, 2016.
- ItemOpen AccessBrain connectomes in youth at risk for serious mental illness: an exploratory analysis(2022-09-15) Metzak, Paul D.; Shakeel, Mohammed K.; Long, Xiangyu; Lasby, Mike; Souza, Roberto; Bray, Signe; Goldstein, Benjamin I.; MacQueen, Glenda; Wang, JianLi; Kennedy, Sidney H.; Addington, Jean; Lebel, CatherineAbstract Background Identifying early biomarkers of serious mental illness (SMI)—such as changes in brain structure and function—can aid in early diagnosis and treatment. Whole brain structural and functional connectomes were investigated in youth at risk for SMI. Methods Participants were classified as healthy controls (HC; n = 33), familial risk for serious mental illness (stage 0; n = 31), mild symptoms (stage 1a; n = 37), attenuated syndromes (stage 1b; n = 61), or discrete disorder (transition; n = 9) based on clinical assessments. Imaging data was collected from two sites. Graph-theory based analysis was performed on the connectivity matrix constructed from whole-brain white matter fibers derived from constrained spherical deconvolution of the diffusion tensor imaging (DTI) scans, and from the correlations between brain regions measured with resting state functional magnetic resonance imaging (fMRI) data. Results Linear mixed effects analysis and analysis of covariance revealed no significant differences between groups in global or nodal metrics after correction for multiple comparisons. A follow up machine learning analysis broadly supported the findings. Several non-overlapping frontal and temporal network differences were identified in the structural and functional connectomes before corrections. Conclusions Results suggest significant brain connectome changes in youth at transdiagnostic risk may not be evident before illness onset.
- ItemOpen AccessExploring Neurocognition and Functional Outcome in Youth at Risk of Serious Mental Illness(2018-04-20) Romanowska, Sylvia; Addington, Jean; MacQueen, Glenda; Piskulic, DanijelaThere is a growing literature that suggests impairments in neurocognitive, social, and role functioning may be markers of susceptibility for serious mental illness development. This study assessed neurocognitive performance and social and role functioning in a sample of youth at risk of serious mental illness across different clinical stages as described by McGorry and colleagues and compared them to healthy controls. The sample consisted of 243 male and female youths aged 12-26 and included: non-help-seeking asymptomatic participants with risk factors (Stage 0; n=41); youth with early mood or anxiety symptoms and distress (Stage 1a; n=52); youth with attenuated psychiatric syndromes (Stage 1b; n=108); and healthy controls (n=42). Each participant underwent a comprehensive clinical and neurocognitive assessment. Subjects in Stage 1b had lower scores than healthy controls across all IQ measures, on the composite score of neurocognitive performance, in the domains of processing speed, working memory, attention/vigilance and reasoning and problem solving and on the social and role functioning measures. Subjects in Stage 1b also had lower scores than subjects in Stage 0 across most IQ measures, on the composite score of neurocognitive performance, in the domains of processing speed, working memory, and social cognition and on the social and role functioning measures. This study demonstrates that impairments in neurocognitive performance and social and role functioning can be present in young people experiencing subthreshold psychiatric symptoms and distress in the absence of a diagnosable mental illness. Further, it offers validation to the clinical staging model in that individuals in the higher stages of risk exhibit poorer functioning.
- ItemOpen AccessMeasurement of the Cerebellar Vermis in Bipolar Disorder and the Effect of Lithium Treatment(2014-05-01) Mahnke, Devin; MacMaster, Frank; MacQueen, GlendaPrevious studies have suggested that the cerebellar vermis may be smaller in individuals with bipolar disorder, but these findings are inconsistent and have not considered the potential impact of medication. To address these knowledge gaps, the cerebellar vermis was measured using structural magnetic resonance imaging in both an adolescent and an adult sample. Analysis of variance was performed on the cross-sectional area of the three vermal lobes and on the total area. There were no significant differences between adolescent or adult bipolar subjects compared to healthy controls in any region, regardless of lithium treatment. In addition, a medication-naïve subset of the adult population underwent a two-year course of lithium treatment and was then reassessed. No changes in vermis area were found within subjects across the treatment. These results, combined with literature meta-analysis, indicate no clear effect of either bipolar disorder, or lithium treatment, on the size of the cerebellar vermis.
- ItemOpen AccessReactive and Proactive Mechanisms of Response Inhibition in Gambling Disorder(2017) Sharif-Razi, Maryam; Goghari, Vina; Hodgins, David; Crockford, David; McGrath, Daniel; MacQueen, GlendaResponse inhibition, one component of cognitive control, refers to the ability to inhibit automatic responses and has been found to be impaired in gambling disorder. Recent models of cognitive control distinguish between two mechanisms: reactive (ability to stop in response to a stop-stimulus) and proactive control (ability to anticipate and prepare for a stop). Previous studies have focused on reactive modes of control in gambling disorder. Thus, the primary aim of this study was to assess the mechanisms of response inhibition in individuals with gambling disorder (n=27) and community controls (n=21) using a variant of the traditional stop-signal task. Second, the relationship between trait impulsivity, and reactive and proactive control was examined. No group differences in reactive or proactive control were found. However, one domain of trait impulsivity (premeditation) was associated with worse proactive control in the gambling group. Implications for impulsivity-focused approaches to treatment and future directions are discussed.
- ItemOpen AccessSocial Cognition in People with Bipolar Disorder(2014-12-23) Bobyn, Jacqueline Anne; MacQueen, GlendaBipolar disorder (BD) is a complex psychiatric illness; in addition to mood disturbances, people with this illness experience cognitive dysfunction and neurovegetative shifts. Some people with BD experience difficulty in interpersonal relationships. Impairment in social cognition may contribute to these difficulties in interpersonal functioning. In order to examine the neural and behavioral correlates of social cognition in patients with BD, a social cognition task was administered to 25 healthy controls (HCs) and 25 patients with BD and depression scores ranging from euthymic to depressed at the time of assessment. The task required participants to evaluate situations that were “enhancing” or “threatening” to self-esteem. Patients differed significantly from HCs in their evaluation of threatening scenarios, directed at both oneself and at other people (p<0.001). Neuroimaging results reveal differential patterns of prefrontal-cortical and limbic-subcortical activation in patients [p<0.001]. Findings may contribute to understanding alterations in social cognitive functioning in patients with BD.
- ItemOpen AccessStructural and Functional Alterations of the Brain’s Deep Grey Matter in Patients with Primary Biliary Cholangitis(2018-01-04) Mosher, Victoria; Goodyear, Bradley; MacQueen, Glenda; Swain, Mark; Dunn, Jeffrey; Addington, JeanPrimary biliary cholangitis (PBC) is an autoimmune liver disease that results in the destruction of the intrahepatic bile ducts. If left untreated, PBC can progress to liver failure or death within 10-20 years. Treatment with ursodeoxycholic acid (UDCA) can delay disease progression, but it does not work in approximately one third of patients, and it has no impact on behavioural symptoms commonly reported by PBC patients, including itch, mood disturbances, fatigue and cognitive deficits. Despite the negative impact these symptoms have on quality of life and survival, little is known about how (or even if) symptoms may impact the brain. In this thesis, we used a selection of structural and functional magnetic resonance imaging techniques to determine the impact of PBC on the brain's deep grey matter regions. We found that the functional connections between deep grey matter regions and higher-order cognitive brain regions were increased in strength, suggesting that brain networks compensate in order to maintain homeostasis in response to the immune insult from the liver. Decreased volume was observed for the thalamus, the hippocampus and a number of hippocampal subfields. In addition, regions of the brain involved in interoception showed evidence of neuroinflammation in relation to disease and symptom severity. These structural findings suggest that some brain changes observed in PBC patients may be irreversible. For most of our findings, a complete clinical response to UDCA did not impact the functional or structural brain alterations observed, suggesting these changes may occur early on in disease progression. Overall, our findings suggest early intervention may be needed to halt changes in the brain resulting from immune-mediated insults The studies within this thesis provide a base of knowledge for how behavioural symptoms may impact the brain and offer suggestions on how future research can build upon these findings.
- ItemOpen AccessThe relationship between depression risk perception and self-help behaviours in high risk Canadians: a cross-sectional study(2020-06-06) Warner, Emily; Nannarone, Molly; Smail-Crevier, Rachel; Manuel, Douglas; Lashewicz, Bonnie; Patten, Scott; Schmitz, Norbert; MacQueen, Glenda; Wang, Jian LAbstract Background Self-help may reduce the risk of depression, and risk perception of depression may influence initiating self-help. It is unknown how risk perception is associated with self-help behaviours. The objectives of this study are to (1) describe the self-help strategies used by high-risk Canadians in relation to the accuracy of perceived depression risk, by sex, and (2) identify demographic and clinical factors associated with self-help behaviours. Methods Baseline data from a randomized controlled trial including 358 men and 356 women at high-risk of developing depression were used. Following methods used in cancer research, risk perception accuracy was determined by comparing the participant’s self-perceived and objective risk of developing depression and classifying as accurate, over-estimation and under-estimation based on a ± 10% threshold. The participant’s objective depression risk was assessed using sex-specific multivariable risk predictive algorithms. Frequency of using 14 self-help strategies was assessed. One-way ANOVA testing was used to detect if differences in risk perception accuracy groups existed, stratified by sex. Linear regression was used to investigate the clinical and demographic factors associated with self-help behaviours, also stratified. Results Compared to accurate-estimators, male over-estimators were less likely to “leave the house daily,” and “participate in activities they enjoy.” Male under-estimators were also less likely to “participate in activities they enjoy.” Both male ‘inaccurate’ perception groups were more likely to ‘create lists of strategies which have worked for feelings of depression in the past and use them’. There were no significant differences between self-help behaviours and risk perception accuracy in women. Regression modeling showed negative relationships between self-rated health and self-help scores, irrespective of sex. In women, self-help score was positively associated with age and educational attainment, and negatively associated with perceived risk. In men, a positive relationship with unemployment was also seen. Conclusions Sex differences exist in the factors associated with self-help. Risk perception accuracy, work status, and self-rated health is associated with self-help behaviours in high-risk men. In women, factors related to self-help included age, education, self-rated health status, and perceived risk. More research is needed to replicate findings. Trial registration Prospectively registered at ClinicalTrials.gov (NCT02943876) as of 10/21/16.
- ItemOpen AccessYouth at-risk for serious mental illness: methods of the PROCAN study(2018-07-05) Addington, Jean; Goldstein, Benjamin I; Wang, Jian L; Kennedy, Sidney H; Bray, Signe; Lebel, Catherine; Hassel, Stefanie; Marshall, Catherine; MacQueen, GlendaAbstract Background Most mental disorders begin in adolescence; however, there are gaps in our understanding of youth mental health. Clinical and policy gaps arise from our current inability to predict, from amongst all youth who experience mild behavioural disturbances, who will go on to develop a mental illness, what that illness will be, and what can be done to change its course and prevent its worsening to a serious mental illness (SMI). There are also gaps in our understanding of how known risk factors set off neurobiological changes that may play a role in determining who will develop a SMI. Project goals are (i) to identify youth at different stages of risk of SMI so that intervention can begin as soon as possible and (ii) to understand the triggers of these mental illnesses. Method This 2-site longitudinal study will recruit 240 youth, ages 12–25, who are at different stages of risk for developing a SMI. The sample includes (a) healthy individuals, (b) symptom-free individuals who have a first-degree relative with a SMI, (c) youth who are experiencing distress and may have mild symptoms of anxiety or depression, and (d) youth who are already demonstrating attenuated symptoms of SMI such as bipolar disorder or psychosis. We will assess, every 6 months for one year, a wide range of clinical and psychosocial factors to determine which factors can be used to predict key outcomes. We will also assess neuroimaging and peripheral markers. We will develop and validate a prediction algorithm that includes demographic, clinical and psychosocial predictors. We will also determine if adding biological markers to our algorithm improves prediction. Discussion Outcomes from this study include an improved clinical staging model for SMI and prediction algorithms that can be used by health care providers as decision-support tools in their practices. Secondly, we may have a greater understanding of clinical, social and cognitive factors associated with the clinical stages of development of a SMI, as well as new insights from neuroimaging and later neurochemical biomarker studies regarding predisposition to SMI development and progression through the clinical stages of illness.