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Guidelines of practicing psychiatry in canada

Stacey D Espinet, Sandra Gotovac, Sommer Knight, Merrick Zwarenstein, Lorelei Lingard, Margaret Steele
Background: Primary care providers (PCPs) are increasingly called upon to assist in meeting the growing demand for paediatric mental health care in Canada, yet they report inadequate training and confidence to do so. The Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program was designed to fill this gap by teaching PCPs the skills needed to provide frontline care themselves, particularly in rural/remote regions where specialist resources are limited. This innovative educational intervention may improve paediatric mental health care capacity, but a pilot study is needed...
November 2018: Journal of the Canadian Academy of Child and Adolescent Psychiatry
Suzanne D Turner, Sheryl Spithoff, Meldon Kahan
OBJECTIVE: To review the clinical features and complications of at-risk cannabis use and cannabis use disorder, and to outline an office-based protocol for screening, identifying, and managing this disorder. SOURCES OF INFORMATION: PubMed was searched for controlled trials, observational studies, and reviews on cannabis use among adolescents and young adults; cannabis-related medical and psychiatric harms; cannabis use disorder and its treatment; and lower-risk cannabis use guidelines...
September 2014: Canadian Family Physician M├ędecin de Famille Canadien
Louise Rose, Robert A Fowler, Eddy Fan, Ian Fraser, David Leasa, Cathy Mawdsley, Cheryl Pedersen, Gordon Rubenfeld
BACKGROUND: We sought to describe prevalence and care practices for patients experiencing prolonged mechanical ventilation (PMV), defined as ventilation for 21 or more consecutive days and medical stability. METHODS: We provided the survey to eligible units via secure Web link to a nominated unit champion from April to November 2012. Weekly telephone and e-mail reminders were sent for 6 weeks. RESULTS: Response rate was 215 (90%) of 238 units identifying 308 patients requiring PMV on the survey day occupying 11% of all Canadian ventilator-capable beds...
February 2015: Journal of Critical Care
Venkat Bhat, Kawai Leong, Jonathan Lee, Daphne Voineskos, Zafiris J Daskalakis, Raymond W Lam, Fabrice Jollant
OBJECTIVES: Clinician-scientists occupy an interesting position at the interface between science and care, and have a role to play in bridging the 2 valleys between fundamental and clinical research, and between clinical research and clinical practice. However, research training during medical residency for future clinician scientists is an important but challenging process. Our article, written by residents and directors of research-track (RT) programs, aimed at reviewing literature on RT programs for residents, and describing the organization of RT programs at 3 Canadian universities (the University of British Columbia, the University of Toronto, and McGill University)...
May 2014: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Stephanie L Leon, Mario Cappelli, Samina Ali, William Craig, Janet Curran, Rebecca Gokiert, Terry Klassen, Martin Osmond, Shannon D Scott, Amanda S Newton
OBJECTIVE: To describe emergency mental health services in major paediatric centres across Canada. METHODS: A cross-sectional study of mental health services in emergency departments (EDs) from all 15 Canadian tertiary care paediatric centres was conducted. RESULTS: Fifteen individuals participated and were either a paediatric emergency physician with administrative responsibilities (60%) or an emergency mental health care provider (40%). Four participants reported that their ED used an evidence-based guideline, tool or policy, and one participant reported their ED based its services on published research evidence...
February 2013: Paediatrics & Child Health
Tamara Pringsheim, Asif Doja, Daniel Gorman, Duncan McKinlay, Lundy Day, Lori Billinghurst, Alan Carroll, Yves Dion, Sandra Luscombe, Thomas Steeves, Paul Sandor
This article seeks to provide the practising clinician with guidance on the pharmacological management of tic disorders in children and adults. We performed a systematic review of the literature on the treatment of tic disorders. A multi-institutional group of 14 experts in psychiatry, child psychiatry, neurology, pediatrics, and psychology engaged in a consensus meeting. The evidence was presented and discussed, and nominal group techniques were employed to arrive at consensus on recommendations. A strong recommendation is made when the benefits of treatment clearly outweigh the risks and burdens, and can apply to most patients in most circumstances without reservation...
March 2012: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Rakesh Jetly
Not since the Korean War have the Canadian Forces engaged in combat missions like those in Afghanistan. Combat, asymmetric warfare, violent insurgency and the constant threat of improvised explosive devices all contribute to the psychological stressors experienced by Canadian soldiers. Mental health teams deployed with the soldiers and provided assessment, treatment and education. Lessons learned included refuting the myth that all psychological disorders would be related to trauma; confirming that most patients do well after exposure to trauma; confirming that treating disorders in a war zone requires flexible and creative adaptation of civilian treatment guidelines; and confirming that in a combat mission mental health practice is not limited to the clinical setting...
December 2011: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Rob Whitley, Cecile Rousseau, Elizabeth Carpenter-Song, Laurence J Kirmayer
In this article we explore the discourse and practice of evidence-based medicine (EBM) in the context of social and cultural diversity. The article consists of 2 parts. First, we begin by defining EBM, describing its historical development and current ascendance in medical practice. We then note its importance in contemporary psychiatry, comparing dynamics between the United States and Canada. Secondly, we offer a constructive critique of the application of EBM and evidence-based practices in the context of ethnocultural diversity, as one consistent reflection on the EBM literature is that it is does not adequately address issues of diversity...
September 2011: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Jonathan R T Davidson
The various major American and European guidelines for the treatment of depression provide similar basic principles of treatment, which include individualizing the treatment plan, preparing the patient for potential long-term treatment, providing measurement-based care, and treating to remission. While the guidelines are all evidence-based, certain factors can influence differences in specific recommendations, such as the consensus group's composition, underlying mandates, and cultural attitudes. The similarities and differences among 6 sets of guidelines from Europe and the Americas published in the past decade are reviewed here (American Psychiatric Association, British Association for Psychopharmacology, Canadian Network for Mood and Anxiety Treatments, National Institute for Health and Clinical Excellence, Texas Medication Algorithm Project, and World Federation of Societies of Biological Psychiatry)...
2010: Journal of Clinical Psychiatry
Priyanthy Weerasekera, John Manring, David John Lynn
OBJECTIVE: The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies selected for training are evidence based and the authors review research concerning methods for training and assessment that effectively lead to competence in these psychotherapies...
January 2010: Academic Psychiatry
Tiago Moreira, Julian C Hughes, Thomas Kirkwood, Carl May, Ian McKeith, John Bond
BACKGROUND: Mild cognitive impairment (MCI) is proposed to describe the transitional stage between normal cognitive aging and dementia. It has had significant impact in the field of dementia research, but it remains controversial whether or not it should be used as a diagnostic category in clinical practice. METHODS: Semi-structured interviews were carried out with international experts (N = 37) in the field of dementia research and practice. These interviews explored the advantages and difficulties of using MCI as a clinical diagnosis...
August 2008: International Psychogeriatrics
Roy J O'Shaughnessy
Canadian legal tests of fitness to stand trial, while similar to tests in the United States, place less emphasis on rational understanding of the complexities of the trial process and greater emphasis on communicating with legal counsel. The limited cognitive capacity test has gained wide acceptance in Canadian jurisprudence as a balance between ensuring that an accused person can provide the necessary information to allow his legal counsel to defend him adequately while also minimizing the potential delay in a speedy trial...
2007: Journal of the American Academy of Psychiatry and the Law
Tamison Doey, Kenneth Handelman, Jamie A Seabrook, Margaret Steele
OBJECTIVE: To describe self-reported patterns of prescribing atypical antipsychotics (ATAs) and monitoring practices of child psychiatrists and developmental pediatricians in Canada. METHOD: We surveyed members of the Canadian Academy of Child and Adolescent Psychiatry and members of the Developmental Paediatrics Section of the Canadian Paediatric Society regarding the types and frequencies of ATAs they prescribed, the ages and diagnoses of patients for whom they prescribed these medications, and the types and frequencies of monitoring used...
June 2007: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Paula Ravitz, Ivan Silver
Acquiring expertise in psychotherapy is central to the professional development of psychiatrists able to employ a broad therapeutic repertoire in their clinical practice. This article reviews how postgraduate psychiatry programs address this important aspect of training. We present the results of a national survey of psychotherapy education in Canadian psychiatry residency programs. The results highlight significant advances over the past decade in curriculum, in teaching methods, and in evaluation. These include training in evidence-based, manualized, time-limited therapies such as cognitive-behavioural and interpersonal therapy, greater attention to evaluating competence, and integrating electronic technology...
April 2004: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Andrea D Grabovac, Soma Ganesan
OBJECTIVE: Mental health professionals are increasingly aware of the need to incorporate a patient's religious and spiritual beliefs into mental health assessments and treatment plans. Recent changes in assessment and treatment guidelines in the US have resulted in corresponding curricular changes, with at least 16 US psychiatric residency programs now offering formal training in religious and spiritual issues. We present a survey of training currently available to Canadian residents in psychiatry and propose a lecture series to enhance existing training...
April 2003: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Edward Yuzda, Kathryn Parker, Vivien Parker, Justin Geagea, David Goldbloom
OBJECTIVE: A national survey of senior psychiatric residents' experience of electroconvulsive therapy (ECT) training was undertaken in Canada in 1989. Since then, guidelines have been published in Canada and the US with respect to ECT training in psychiatry residency programs. This study examines whether there has been any change in the Canadian resident ECT training experience through a second national survey. METHODS: Confidential questionnaires assessing the training in and the attitudes toward ECT were sent to all 133 psychiatric residents-in their final year of training in Canadian medical schools...
December 2002: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
(no author information available yet)
This clinical practice guideline provides evidence-based recommendations for the treatment of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). This guideline, the second in a set of policies on this condition, is intended for use by clinicians working in primary care settings. The initiation of treatment requires the accurate establishment of a diagnosis of ADHD; the American Academy of Pediatrics (AAP) clinical practice guideline on diagnosis of children with ADHD(1) provides direction in appropriately diagnosing this disorder...
October 2001: Pediatrics
C Patterson, S Gauthier, H Bergman, C Cohen, J W Feightner, H Feldman, A Grek, D B Hogan
OBJECTIVE: i) To develop evidence based consensus statements on which to build clinical practice guidelines for primary care physicians towards the recognition, assessment and management of dementing disorders; ii) to disseminate and evaluate the impact of these statements and guidelines built on these statements. OPTIONS: Structured approach to assessment, including recommended laboratory tests, choices for neuroimaging and referral; management of complications (especially behaviour problems and depression) and use of cognitive enhancing agents...
February 2001: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
C J Patterson, S Gauthier, H Bergman, C A Cohen, J W Feightner, H Feldman, D B Hogan
OBJECTIVE: To develop evidence based consensus statements on which to build clinical practice guidelines for primary care physicians toward the recognition, assessment and management of dementing disorders and to disseminate and evaluate the impact of these statements and guidelines built on these statements. OPTIONS: Structured approach to assessment, including recommended laboratory tests, choices for neuroimaging and referral, management of complications (especially behavioural problems and depression) and use of cognitive enhancing agents...
June 15, 1999: Canadian Medical Association Journal: CMAJ
J P Reiss
No abstract text is available yet for this article.
June 1994: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
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