Background The perinatal period represents a phase of increased psychiatric vulnerability, yet the factors linked to severe mental illnesses (SMIs) diagnosed during pregnancy or postpartum remain unclear. This study sought to identify associated and predictive factors of depression, bipolar disorder, and schizophrenia-related disorders diagnosed during pregnancy vs postpartum, with or without psychiatric comorbidity, in women seeking psychiatric care.Methods Using a retrospective cohort design, data from 927 women who accessed specialized perinatal psychiatric services in Quebec City (Canada) were analyzed. Poisson regression models examined psychiatric, sociodemographic, medical, and obstetric correlates of perinatal SMIs.Results Distinct profiles emerged according to diagnosis timing, disorder type, and comorbidity. During pregnancy, associated factors included being single, absence of prior psychotropic use, musculoskeletal conditions, and cluster C personality disorders. Past postpartum psychosis predicted bipolar disorder diagnosed during pregnancy. In the postpartum period, key correlates included history of anxiety or (hypo)manic symptoms, somatic-related disorder, suicidal behavior, absence of previous psychiatric diagnosis, and no new diagnosis during pregnancy. Foreign nativity and lack of psychotropic treatment were linked to depression across both periods.Conclusions Results highlight period-specific and shared factors underlying perinatal SMIs. Their identification may improve early detection and targeted interventions for maternal mental health.

Purpose: This study examines the critical role of interactive and linguistic features of the family environment in the language and speech developmental trajectories of children with a history of neglect. The proposed hypothesis is that the quality of interactive features will be the primary determinant of whether children follow a normative (control-like) or low developmental trajectory. Method: Data were collected from the Early Longitudinal Language and Neglect study conducted in Quebec (Canada), involving 41 children who had experienced neglect, living in either biological or foster families. Children's language and speech development was assessed through measures of expressive and receptive vocabulary, mean length of utterance, and percentage of words correct at six time points between 36 and 66 months of age. The child's language and speech development was classified into one of two categories: normative or low. Parent-child interactive and linguistic features were analyzed using 15-min video recordings of semistructured play sessions conducted at home. Results: Low levels of parental interactive features-such as sensitivity, reactivity, and reciprocity-were positively associated with lower language and speech trajectories in children. Among linguistic features, only the parental mean length of utterance showed a significant link to low trajectories. These patterns were observed consistently in both biological and foster families. Conclusions: The findings demonstrate that interactive features play a critical role in shaping the language and speech trajectories of children experiencing neglect, even more so than linguistic features. This study highlights the importance of high-quality interactions with parents in mitigating the negative effects of neglect on language and speech development. A targeted and adaptive approach, emphasizing parental strengths, has the potential to significantly improve developmental outcomes for children growing up in contexts of adversity. Supplemental Material: https://doi.org/10.23641/asha.30888404

This feasibility randomized controlled trial (RCT) evaluated "Children and Teens in Charge of Their Health" (CATCH), a solution-focused coaching intervention promoting physical activity and healthy eating in children with spina bifida or cerebral palsy. All participants received standard care and printed materials; the intervention group also received up to eight coaching sessions over six months. Quantitative analyses examined whether a priori feasibility criteria were met and the responsiveness of measures assessing goal attainment, functional mobility, dietary intake and physical activity at four timepoints over 12 months. Nineteen participants were randomized. While stratification and fidelity criteria were met, recruitment and retention were not, likely impacted by Covid-19. CATCH participants showed significant improvements in two of three goal attainment scores, along with positive trends in functional mobility, active hours, and some dietary measures compared to controls. Most outcome measures were responsive, although protocol adaptations are needed for a full-scale RCT.

BackgroundMore than one in five women deal with a psychiatric disorder during the perinatal period. Whereas perinatal depression is well documented, there is still little research on the full range of perinatal psychiatric disorders and their clinical evolution across this whole period. The present study investigated the susceptibility to psychiatric illness during pregnancy and up to one year postpartum. We aimed to identify the most frequent disorders and comorbidities arising in each perinatal period. We outlined the clinical trajectories of these disorders in terms of evolution across past history, pregnancy and postpartum.MethodThrough a retrospective longitudinal design, data were collected in 2019-2020 from the medical records of the cohort of 964 women who required care in a tertiary perinatal psychiatry clinic located in Quebec City (Canada) between 2004 and 2020. Incidence rates of the full range of psychiatric disorders were estimated per period and their evolution across time identified clinical trajectories.ResultsDuring pregnancy, 34 different disorders were newly diagnosed with incidence rates ranging from 0.1% to 15.5% (45.6% of women having had at least one disorder diagnosed during pregnancy) whereas, during postpartum, 36 disorders were newly diagnosed with incidence rates ranging from 0.1% to 31.0% (67.5% of women having had at least one disorder diagnosed during postpartum). For most disorders, rates were significantly higher in postpartum than in pregnancy. A woman could develop multiple disorders during a given perinatal period: this comorbidity involved various combinations of diagnoses in 28% of women during pregnancy and 38% during postpartum. We outlined 52 different clinical trajectories from past history to postpartum, underlining the heterogeneity of the perinatal course.ConclusionsPregnancy is a susceptible period for women with past psychiatric histories whereas postpartum could trigger a new illness in women without a past history or pregnancy-onset psychiatric disorder.

SummaryThe present study evaluates the efficacy of behavioural therapy adapted for shift work disorder with a randomised control design in a healthcare population. Forty‐three night shift workers (m. age: 34 years; 77% women) experiencing shift work disorder were randomised to either the behavioural therapy for shift work disorder (BT‐SWD) or a waiting‐list control group offered after the waiting period. Participants completed questionnaires on insomnia, sleepiness and mental health pre‐ and post‐treatment, pre‐ and post‐waiting, and at follow‐up, and a sleep diary. As night shift workers alternate between sleeping during the day after their night shifts and transitioning to nighttime sleep on days off, insomnia severity and sleep variables were analysed for daytime and nighttime sleep. The BT‐SWD involved sleep restriction therapy, stimulus control and fixed sleep periods in the dark. Statistical analyses were performed under intent‐to‐treat and per‐protocol approaches. Repeated‐measures two‐way ANCOVA analysis, controlling for age, sex and pre‐treatment daytime total sleep time, was performed with Bonferroni corrections, and between‐group effect sizes computed. Fourteen participants dropped out after randomisation. Under the intent‐to‐treat analysis, BT‐SWD participants had a significant greater decrease in daytime insomnia severity and an increase in daytime total sleep time at post‐treatment than the control group, with large between‐group effect sizes (−1.25 and 0.89). These corresponding results were also significant with large effect sizes under the per‐protocol analysis. Sleepiness, anxiety and depression levels improved at post‐treatment and maintained at follow‐up when the BT‐SWD treated controls were added to the BT‐SWD group. The behavioural therapy for shift work disorder can be used to improve the sleep and mental health of healthcare night workers.

BACKGROUND:The retina is recognized as an accessible part of the brain due to their common embryonic origin. The electroretinogram (ERG) has proven to be a valuable tool for detecting schizophrenia and bipolarity. We therefore investigated its ability to detect ADHD.METHODS:The cone and rod luminance response functions of the ERG were recorded in 26 ADHD subjects (17 women and 9 men) and 25 controls (16 women and 9 men).RESULTS:No significant differences were found between the mixed groups, but sexual dysmorphia was observed in the significant results. In males, a significant prolonged cone a-wave latency was observed in the ADHD group. In females, we observed a significant decrease in the cone a- and b-wave amplitudes and a trend for a prolonged cone b-wave latency as well as a higher scotopic mixed rod-cone a-wave in the ADHD group.CONCLUSION:The data obtained in this study show the potential of the ERG to detect ADHD, warranting further large-scale studies.

Background: Neglected children are at high risk for significant difficulties in speech and language development. Because no longitudinal study has been conducted to date, the dynamic description of development during the preschool period is unknown.Objectives: Establish the developmental trajectories of speech sounds, receptive and expressive vocabulary, and morphosyntax among neglected children during the preschool years and compare them with those of non-neglected children. Participants and setting: Participants are 69 neglected children and 99 same age non-neglected peers (37 and 46 males respectively) recruited at 36 months of age. Data were collected at home.Methods: Data were collected at six-month intervals between the ages of 3 and 5.5 years using psychometrically robust tools. Neglected and control groups were compared according to age using repeated measures ANOVAs on all variables. A discrete mixture model for clustering longitudinal data was used for testing the heterogeneity of the language trajectories among neglected children. Results: The language development of the neglected children as a whole group is lower than that of the control group for all variables. Two subgroups are identified within the neglected group: one with a developmental trajectory similar to that of the non-neglected children, and another whose trajectory is far below that of the control group. The effect sizes of these differences vary between 1.4 and 3 standard deviations under the mean. Conclusions: A large proportion of neglected children present significant speech and language difficulties from the age of 3, but some of them catch up and develop similarly to non-neglected children.

We previously proposed the electroretinogram (ERG) as a promising biomarker of major psychiatric disorders such as schizophrenia (SZ) and bipolar disorder (BP), given that we found anomalies in the ERG parameters of patients with these diagnoses as well as in their children who are at high risk (HR) of developing such disorders. The aim of the present study is to investigate the usefulness of the ERG for individual detection, among HR children, of an ERG profile resembling that of a SZ patient, as this may indicate a stronger likelihood of transition to psychosis. Using a logistic regression model previously derived from the ERG assessments of SZ patients and control (CT) subjects, individual risk scores were obtained for 61 HR and 80 CT youth. Those with a very high individual risk score were classified as "schizophrenia-like" (SZ-like). We found that the HR subjects were 3.5 times more likely to be classified as SZ-like than the CT subjects (95% CI [1.1-11.8]). Furthermore, among the HR subjects, we studied the relationship between the SZ-like classification and psychotic-like experiences and found that HR subjects classified as SZ-like were 2.7 times more likely than all remaining HR subjects to have experienced psychotic-like symptoms (95% CI [1.3-4.6]), and 6.8 times more likely than those with a very low individual risk score (95% CI [1.4-40.4]). Our results suggest that a model previously derived from ERG data on SZ patients could be a potential tool for early detection of the susceptibility to a psychotic-like disorder among familial HR children.

Background We have shown that electroretinograms can discriminate between patients with severe mental illness (SMI) and healthy controls in previous studies. We now intend to enhance the development and clinical utility of ERG as a biological tool to monitor the risk of SMI. Methodology A sample of 301 SMI patients (bipolar disorder or schizophrenia) and 200 controls was first split into a training ( N = 401) and testing dataset ( N = 100). A logistic regression using ERG was modeled in the training data, while external validation and discriminative ability were assessed in the testing data. A decision curve analysis was used to test clinical usefulness. Moreover, the identification of thresholds of uncertainty based on the two-graph ROC and the interval of uncertainty was used to enhance prediction. Results The discriminative assessment of the ERG showed very high sensitivity (91%) and specificity (89%) after considering uncertainty levels. Furthermore, for prediction probabilities ranging from 0.14 to 0.95 in the testing data, the net benefit of using our ERG model to decide whether to intervene or not exceeded that of never or always intervening. Conclusion The ERG predicted SMI risk with a high level of accuracy when uncertainty was accounted for. This study further supports the potential of ERG to become a useful clinical decision tool to decide the course of action for subjects at risk of SMI. However, further investigation is still needed in longitudinal studies to assess the external validity of the instrument.

Introduction The COVID-19 pandemic and associated restrictive measures have caused important disruptions in economies and labour markets, changed the way we work and socialise, forced schools to close and healthcare and social services to reorganise. This unprecedented crisis forces individuals to make considerable efforts to adapt and will have psychological and social consequences, mainly on vulnerable individuals, that will remain once the pandemic is contained and will most likely exacerbate existing social and gender health inequalities. This crisis also puts a toll on the capacity of our healthcare and social services structures to provide timely and adequate care. The MAVIPAN (Ma vie et la pandémie/ My Life and the Pandemic) study aims to document how individuals, families, healthcare workers and health organisations are affected by the pandemic and how they adapt. Methods and analysis MAVIPAN is a 5-year longitudinal prospective cohort study launched in April 2020 across the province of Quebec (Canada). Quantitative data will be collected through online questionnaires (4–6 times/year) according to the evolution of the pandemic. Qualitative data will be collected with individual and group interviews and will seek to deepen our understanding of coping strategies. Analysis will be conducted under a mixed-method umbrella, with both sequential and simultaneous analyses of quantitative and qualitative data. Ethics and dissemination MAVIPAN aims to support the healthcare and social services system response by providing high-quality, real-time information needed to identify those who are most affected by the pandemic and by guiding public health authorities’ decision making regarding intervention and resource allocation to mitigate these impacts. MAVIPAN was approved by the Ethics Committees of the Primary Care and Population Health Research Sector of CIUSSS de la Capitale-Nationale (Committee of record) and of the additional participating institutions. Trial registration number NCT04575571 .

Abstract Depression is a major mental health disorder, and its pathophysiology is still largely unknown, as is the action mechanism of electroconvulsive therapy (ECT). Some evidence suggests that inflammation might play a role in depression, and several studies have attempted to demonstrate a link between ECT and cytokines. This systematic review used a qualitative analysis to assess the effect of ECT on inflammatory markers as it relates to the clinical response of depressive symptoms in major depressive disorders. The bibliographic search engines CINAHL, Embase, PsychInfo, and PubMed were used to identify articles published up to July 2020. Search terms related to depression, ECT, and inflammation were used. Descriptive statistical analyses were performed to relate changes in inflammatory markers to clinical response to ECT. Twenty-five studies were included in the analysis. No systematic increases or decreases were found in a given inflammatory marker over the ECT; however, we observed that tumor necrosis factor α and interleukin-6 (IL-6) were more often found to be decreased after ECT, whereas IL-8 and IL-10 were more often found to be increased after treatment. No trend in correlation was found between the degree of clinical improvement of depressive symptoms and the variation of any inflammatory markers, despite positive clinical response to ECT. Great heterogeneity with regard to methodology used and lack of power of the studies included in this review could explain the lack of systematic change and correlation found in this study. Future research conducted on this subject should take into account these methodological limitations to allow subsequent meta-analysis.

Objective: The goal of this study was to validate the French version of the Quality of Life in Bipolar Disorder (QoL.BD) scale, a condition-specific measure for bipolar disorder (BD). Method: The QoL.BD scale was translated into French in accordance with the recommendations for transcultural adaptation. It was administered to 125 participants with BD living in Quebec, Canada. Construct validity was evaluated through correlations with other measures of self-reported quality of life (QoL), functioning, and symptoms. Factorial structure was examined through an exploratory factor analysis. Results: Internal reliability and test–retest reliability standards were met. Correlations in expected directions with other QoL, functioning, and depressive symptom scales supported convergent validity. The item loadings structure of the French QoL.BD largely replicated the original English version, with some modifications. Conclusion: The French version of the QoL.BD (full and brief) is comparable in its psychometric properties to the English version. It is a valid and sound measure for the evaluation of the QoL of French-speaking patients with BD.

To better understand Shift Work Disorder (SWD), this study investigates insomnia, sleepiness, and psychosocial features of night workers. The study compares night workers with or without SWD to day workers with or without insomnia. Seventy-nine night workers and 40 day workers underwent diagnostic interviews for sleep disorders and for psychopathologies. They completed questionnaires and a sleep diary for 14 days. The design was observatory upon two factors: Work schedule (night, day work) and sleep (good sleep, SWD/insomnia). Two-way ANCOVAs were conducted on psychosocial variables, and effect size were calculated. The clinical approach chosen led to distinct groups of workers. Night workers slept several periods (main sleep period after work, naps, nights on days off). High total wake time and low total sleep time characterized sleep in SWD. Most night workers with SWD still complained of sleepiness after main sleep. Cognitive activation distinguished groups of night workers. All other differences in psychosocial variables between night workers groups were similar to, but smaller than, the ones between day workers. The evaluation of SWD should consider all sleep periods of night workers with particular attention to self-reported total wake time, state sleepiness, and level of cognitive activation.

Abstract Introduction Around 33% of shift workers suffer from shift work disorder (SWD). SWD includes insomnia and sleepiness related to the atypical work schedule. Most SWD treatments rely on light therapy or pharmacology. Few studies explored CBT-I efficacy for insomnia in shift work and reported promising results. The study aims to evaluate the efficacity of a behavioral therapy for insomnia adapted for SWD (BT-SWD). Methods Forty-three night shift workers meeting SWD criteria were recruited (mean age = 34 years old; 77% women) and randomized to either BT-SWD or waiting list control group. Eight participants dropped-out while waiting. Before and after treatment, participants completed questionnaires (ESS, ISI, STAI and BDI-II) and sleep diaries throughout the experimentation. BT-SWD involves sleep restriction therapy and stimulus control for insomnia as well as fixed sleep periods in the dark for shift workers. BT-SWD has been applied to night sleep, day sleep, and naps in this order. It consists of 6 sessions of 50 minutes delivered on 8 weeks. A mixed MANOVA was conducted on questionnaires scores with group (treatment or waitlist) as the between-subject factor and time as the within subject factor. Results A multivariate interaction effect was significant, F(6,21) = 8.24, p<.001. A univariate interaction effect was observed for the BDI-II (p=.042), the trait scale of the STAI (p=.021) and the ISI, both for night sleep (p=.027) and day sleep (p<.001), indicating that the scores of participants in the treatement group lowered significantly more than those of participants on the waiting group. The treatment group had a significantly less severe insomnia, both for day sleep during night work (p<.001), and night sleep during days off (p<.001). There was no significant difference between the control and the treatment group on sleepiness levels. Conclusion BT-SWD is effective at reducing insomnia severity as well as levels of trait anxiety and depression. Results are more equivocal for sleepiness. The waiting list control group design used has led to an important attrition in the context of shift work. Further analyses are needed to determine the BT-SWD efficacy on sleep variables. Support (if any) The study was supported by a CIHR grant (#110254) awarded to the first author

Study Objectives: The study objectives were to examine accidental risks associated with insomnia or hypnotic medications, and how these risk factors interact with sex and age. Methods: A population-based sample of 3,413 adults (M-age = 49.0 years old; 61.5% female), with or without insomnia, were surveyed annually for five consecutive years about their sleep patterns, sleep medication usage, and road collisions. Results: There was a significant risk of reporting road collisions associated with insomnia (hazard ratio [HR] =1.20; 95% confidence interval [CI] =1.00-1.45) and daytime fatigue (HR =1.21; 95% CI = 1.01-1.47). Insomnia and its daytime consequences were perceived to have played some contributory role in 40% of the reported collisions. Both chronic (HR = 1.50; 95% CI = 1.17-1.91) and regular use of sleep medications (HR = 1.58; 95% CI = 1.16-2.14) were associated with higher accidental risks, as well as being young female with insomnia and reporting excessive daytime sleepiness. Conclusions: Both insomnia and use of sleep medications are associated with significant risks of road collisions, possibly because of or in association with some of their residual daytime consequences (i.e. fatigue and poor concentration). The findings also highlight a new group of at-risk patients, i.e. young women reporting insomnia and excessive daytime sleepiness.

Importance Insomnia is a significant public health problem, but there is little information on its natural history. Objective To assess the incidence, persistence, and remission rates of insomnia over a 5-year naturalistic follow-up period. Design, Setting, and Participants This cohort study included participants with and without sleep problems selected from the adult population in Canada from August 2007 to June 2014. Participants completed an annual survey about their sleep and health status for 5 consecutive years. Exposure Using validated algorithms, participants were classified at each assessment as being good sleepers (n = 1717), having an insomnia disorder (n = 538), or having subsyndromal insomnia (n = 818). Main Outcomes and Measures Survival analyses were used to derive incidence rates of new insomnia among the subgroup of good sleepers at baseline and persistence and remission rates among those with insomnia at baseline. Sleep trajectories were examined by looking at year-person transitions between each consecutive year summed over the 5-year follow-up period. All inferential analyses were weighted according to normalized sampling weights. Results The sample included 3073 adults (mean [SD] age, 48.1 [15.0] years; range, 18.0-95.0 years; 1910 [62.2%] female). Overall, 13.9% (95% CI, 11.0%-17. 5%) of initial good sleepers developed an insomnia syndrome during the 5-year follow-up period, and incidence rates were higher among women than among men (17.6% [95% CI, 13.6%-22.7%] vs 10.1% [95% CI, 6.6%-15.3%; chi(2) = 4.43; P = .03). A total of 37.5% (95% CI, 32.6%-42.5%) of participants with insomnia at baseline reported insomnia persisting at each of the 5 annual follow-up times. For subsyndromal insomnia, rates were 62.5% at 1 year to 26.5% at 5 years. For syndromal insomnia, rates were 86.0% at 1 year to 59.1% at 5 years. Conversely, remission rates among those with subsyndromal insomnia were almost double the rates among those with an insomnia syndrome at 1 year (37.5% [95% CI, 31.7%-44.0%] vs 14.0% [95% CI, 9.3%-20.8%]), 3 years (62.7% [95% CI, 56.7%-68.7%] vs 27.6% [95% CI, 20.9%-35.9%]), and 5 years (73.6% [95% CI, 68.0%-78.9%%] vs 40.9% [95% CI, 32.7%-50.4%]). Yearly trajectories showed that individuals who were good sleepers at baseline were 4.2 (95% CI, 3.51-4.89) times more likely to stay good sleepers in the subsequent year, but once they developed insomnia, they were equally likely to report symptoms (47% probability) than to return to a good sleeper status (53% probability) 1 year later. Similarly, those with an insomnia syndrome at any given assessment were more likely (adjusted odds ratio, 1.60; 95% CI, 1.19-2.60) to remain in that status (persistence) than to improve (remittance) at the next assessment; even among those who improved, the odds of relapse were greater (adjusted odds ratio, 2.04; 95% CI, 1.23-3.37) than those to improve in the following year. Conclusions and Relevance The findings suggest that insomnia is often a persistent condition. Considering the long-term adverse outcomes associated with persistent insomnia, these findings may have important implication for the prognosis and management of insomnia. Question What were the incidence, persistence, and remission rates of insomnia over a 5-year period in a population-based sample? Findings In this cohort study of 3073 adults followed up annually for 5 years, 13.9% of those without insomnia at baseline developed an insomnia syndrome during the 5-year follow-up and 37.5% of those with insomnia at baseline reported persisting insomnia at each of the 5 annual follow-up times. Rates of persistent insomnia were higher among individuals with more severe insomnia at baseline, whereas remission was more likely in those with less severe insomnia. Meaning In this study, insomnia was a persistent condition, suggesting that it is important to identify and intervene early with at-risk individuals. This cohort study assess the incidence, persistence, and remission rates of insomnia over a 5-year period in a population-based sample in Canada.

INTRODUCTION:Almost a third of the offspring of parents diagnosed with schizophrenia or bipolar disorder could develop a mental disorder or related symptoms. The objectives of this study were to test the existence of two distinct subgroups of youth at-risk, according to their retinal response to luminance measured with electroretinography (ERG), and to relate the resulting cluster memberships with the cognitive clusters previously reported.METHODOLOGY:A clustering analysis was performed with ERG measurements in 107 at-risk offspring. Each subgroup was compared to a healthy control group of 203 individuals. The ERG subgroup memberships were then associated with the cognitive clusters.RESULTS:A two-cluster solution was obtained: HR-Cluster1 (n=53) showed a control-like ERG profile and HR-Cluster2 (n=54) showed reduced rod amplitudes and prolonged cone latencies of the b-wave. Subjects in the HR-Cluster2 were 2.7 times more likely to belong to the most detrimental cognitive subgroup than subjects in the HR-Cluster1 (49% Vs 18%).CONCLUSION:At-risk offspring showed two distinct ERG profiles: a control-like and an altered profile. A higher risk of impaired cognitive function was observed in subjects with the altered ERG profile, suggesting the ERG as a potential biomarker of susceptibility to mental illness among youth at risk.

Introduction Behavioural and psychological symptoms (BPSD) associated with major neurocognitive disorder (MNCD) represent the psychological and behavioural problems that appear as the disease progresses. BPSD may vary according to the etiology and stage of MNCD, and are associated with a higher risk of premature institutionalization. Non-pharmacological interventions and pharmacological interventions have been widely used to address BPSD. The literature supports the use of an integrated approach including person-centered non-pharmacological and pharmacological interventions. Methods The aim of this study was twofold: to characterize the patient population of a multidisciplinary specialized care unit involving at the IUSMQ in Quebec City using non-pharmacological and pharmacological interventions for patients with severe BPSD symptoms. Second, to evaluate the efficacy of the specialized care unit in reducing BPSD symptoms as measured by the neuropsychiatric inventory (NPI). Data were retrospectively collected from the medical chart and entered into a database. Only the participants for whom a measure of the NPI was recorded at admission and at discharge were included in this study (N = 54 participants). Results Analysis of this clinical sample revealed that the NPI score was significantly reduced at discharge as compared to admission. The subscales showing a statistically significant reduction were agitation/aggression, anxiety, disinhibition, irritability/lability and aberrant motor activity. Conclusions These results suggest that a combined approach implemented by a multidisciplinary team can reap significant benefits for BPSD patients with advanced stage MNCD hospitalized on a special care unit. This research was funded by Cashman-Gauthier foundation Quebec Alzheimer's disease association PDF: http://submissions.mirasmart.com/Verify/AAGP2019/Original/AAGP2019-000339/AAGP2019-000339_Fig1.pdf Results of the paired samples ttest evaluating change in neuropsychiatric symptoms between admission and discharge for N = 54 participants

BACKGROUND:The retina is recognized as an approachable part of the brain owing to their common embryonic origin. The electroretinogram (ERG) has proved to be a valuable tool to investigate psychiatric disorders. We therefore investigated its accuracy as a tool to differentiate schizophrenia (SZ) from bipolar disorder (BP) even after balancing patients for their main antipsychotic medication.METHODS:ERG cone and rod luminance response functions were recorded in 150 patients with SZ and 151 patients with BP and compared with 200 control subjects. We created a subgroup of subjects-45 with SZ and 45 with BP-balanced for their main antipsychotic medication.RESULTS:A reduced cone a-wave amplitude and a prolonged b-wave latency were observed in both disorders, whereas a reduced cone b-wave amplitude was present in SZ only. Reduced mixed rod-cone a- and b-wave amplitudes were observed in both disorders. Patients with SZ were distinguishable from control subjects with 0.91 accuracy, 77% sensitivity, and 91% specificity with similar numbers for patients with BP (0.89, 76%, and 88%, respectively). Patients with SZ and patients with BP could be differentiated with an accuracy of 0.86 (whole sample) and 0.83 (subsamples of 45 patients with 80% sensitivity and 82% specificity). Antipsychotic dosages were not correlated with ERG parameters.CONCLUSIONS:The ERG waveform parameters used in this study provided a very accurate distinction between the two disorders when using a logistic regression model. This supports the ERG as a tool that could aid the clinician in the differential diagnosis of SZ and BP in stabilized medicated patients.

Introduction Children with physical disabilities are rarely included in interventions to promote healthy lifestyles, despite being at higher risk for suboptimal dietary and physical activity behaviours. The Children and Teens in Charge of their Health study explores the feasibility and acceptability of conducting a randomised controlled trial (RCT) of a strengths-based, solution-focused coaching intervention for improving and sustaining physical activity and healthy dietary habits in children and young people with physical disabilities. Methods and analysis Thirty children aged 10-18 years with a diagnosis of spina bifida or cerebral palsy who are able to set healthy lifestyle goals will be recruited from two children's rehabilitation hospitals in Ontario, Canada. Participants will be enrolled in the study for twelve months. All participants will receive standard care and printed information about healthy lifestyles. Of the 30 participants, 15 will be randomised to receive a coaching intervention for the first 6 months. Health indicators and psychosocial outcomes will be assessed by blinded assessors four times: at the start of the trial, immediately postintervention (6 months after randomisation), and at 3 and 6 months postintervention (9 and 12 months after randomisation, respectively). Predefined success criteria will be used to assess the feasibility of trial processes such as recruitment, attrition, stratification and intervention fidelity. Acceptability and perceived impact of the intervention will be explored qualitatively. Ethics and dissemination The study has been approved by Holland Bloorview Kids Rehabilitation Hospital's Research Ethics Board (Ref: 17-752). A knowledge translation planning template will be used to ensure our findings have maximum reach.