Psychiatry

Centre for Addiction and Mental Health

Subheadline

“With every win, you keep pinching yourself to say, ‘Is this real? Is this happening?’”

Juveria Zaheer, a psychiatrist at the Centre for Addiction and Mental Health (CAMH) and the University of Toronto, is set to compete in the Tournament of Champions on Jeopardy! after winning the Group One Champions Wildcard tournament.

An expert on suicide risk and prevention, Zaheer prevailed on Friday’s show with a two-day final score of $20,000, earning her a $100,000 grand prize, reported durhamregion.com.

In an interview on CBC Radio’s Metro Morning, Zaheer – a scientist with CAMH’s Institute for Mental Health Policy Research and General Adult Psychiatry and Health Systems Division and an associate professor of psychiatry in ��˾��ֱ��’s Temerty Faculty of Medicine – recalled how she thought her time on Jeopardy! was up after losing her first game in May 2023.

She returned to the podium last fall and emerged as a Second Chance winner, and after cleaning up in her latest tournament, she says her comeback story feels like something out of a fairytale. “You feel like Cinderella. You just don’t want it to be midnight quite yet,” she told Metro Morning host David Common. “With every win, you keep pinching yourself to say, ‘Is this real? Is this happening?’”

The Tournament of Champions begins airing on Feb. 23.

Listen to Juveria Zaheer on CBC’s Metro Morning

Mindfulness training can help doctors improve well-being and communication, study finds

Christopher.Sorensen — Fri, 24 Nov 2023 16:55:22 +0000

Mindfulness training can help doctors improve well-being and communication, study finds

Christopher.Sorensen Fri, 11/24/2023 - 11:55

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(photo by sturti/Getty Images)

Gabrielle Giroday

Topic

Breaking Research

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Faculty of Arts & Science

New College

Research & Innovation

Subheadline

The research involved doctors who came from a range of specialities, including surgery, psychiatry, emergency medicine and family medicine

A new study involving researchers from the University of Toronto has found mindfulness training for doctors improved their communication with patients and colleagues, and led to positive cognitive and behavioural changes.

The study, by Elli Weisbaum, an assistant professor in the Temerty Faculty of Medicine’s department of psychiatry, was recently published in the Canadian Medical Association Journal. The research looked at the experiences of 28 doctors who received five weeks of mindfulness training.

“This study’s findings are encouraging for all health-care professionals interested in developing healthy and compassionate workplaces. My hope is that these findings contribute to both individual and systems-level change,” said Weisbaum, who is cross-appointed to the Dalla Lana School of Public Health’s Institute of Health Policy, Management and Evaluation and is acting program director for New College’s Buddhism, psychology and mental health program in the Faculty of Arts & Science.

Trevor Young, ��˾��ֱ��’s vice-president and provost, as well as a professor in Temerty Medicine’s departments of psychiatry, and pharmacology and toxicology, and Nicholas Chadi, a clinical assistant professor at the Université de Montréal, co-authored the study.

The research involved doctors who came from a range of specialities, including surgery, psychiatry, emergency medicine and family medicine.

Over a span of five weeks in 2019, participants attended weekly in-person applied mindfulness training sessions, based on the teachings of scholar and Zen Buddhist monk Thích Nhất Hạnh.

Researchers then conducted interviews to understand how the training impacted doctors’ work and daily lives.

“Participants report that integrating brief mindfulness practices at the beginning and end of their workday can lead to more effective regulation of workplace stressors, which can lead to feeling more energized at the end of the day,” the study authors wrote.

“Participants also report that a brief mindful reset at the end of the day can reduce the transfer of occupational stressors, such as frustration, to their home environment.”

As well, participants told researchers that mindfulness training helped them to have better skills when it came to balancing their work and home lives.

They said the training assisted them with giving themselves permission not to rush in their work, while still being efficient and effective.

Participants also reported better communication with their patients and their colleagues as a result of mindfulness training. This included enhanced self-awareness and decreased reactivity when confronted with challenging situations, they told researchers.

The study also found mindfulness training increased focus for physicians during patient interactions, and resulted in a higher awareness by physicians of their own biases around patients.

Ultimately, participants said the skillsets developed through mindfulness training led to more patient-centred diagnoses and treatment plans.

“[Due to mindfulness training,] participants describe having a greater awareness of what they contribute to challenging interactions with patients and colleagues. Through this understanding, they can implement more compassionate communication styles, which helps them set and maintain clearer boundaries for themselves during frustrating or irritating interactions,” the researchers wrote.

Weisbaum says the study’s findings point to the value of mindfulness training for physicians, and that the study is a “call to action” for clinicians and policymakers.

She says there is more research underway to examine how applied mindfulness can help address and mitigate physician burn-out.

“This research shows that mindfulness training benefits physicians at an individual level, through more effective management of occupational stressors,” Weisbaum says. “It also shows potential benefits to [the] broader health-care delivery system.”

Mindfest 2023: Psychiatrist Saadia Sediqzadah offers tips on how to find the right psychotherapist

siddiq22 — Wed, 26 Apr 2023 20:08:09 +0000

Mindfest 2023: Psychiatrist Saadia Sediqzadah offers tips on how to find the right psychotherapist

siddiq22 Wed, 04/26/2023 - 16:08

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Psychiatrist and lecturer Saadia Sediqzadah will speak at ��˾��ֱ��'s Mindfest mental health fair on May 5 about cultural competence in psychotherapy (supplied image)

Ben Gane

Topic

Unity Health

Diversity and Inclusion

In her work as a psychiatrist, Saadia Sediqzadah focuses on mental illness in youth and marginalized populations.

The daughter of Afghan refugees, Sediqzadah is a clinician-investigator at Unity Health Toronto and lecturer in the University of Toronto's department of psychiatry in the Temerty Faculty of Medicine who specializes in early psychosis intervention and supporting marginalized adolescents.

Her clinical practice is primarily outreach-oriented, providing psychiatric care to patients who are homeless, in the shelter system or in Toronto Community Housing. She is also the psychiatrist lead for the Starting Treatment Early in Psychosis Service (STEPS) program, which serves transitional-aged youth with psychotic illnesses, and she provides psychiatric care to youth shelters in Toronto via Inner City Health Associates.

Sediqzadah is one of several speakers scheduled for ��˾��ֱ��’s Mindfest event – a community fair for conversations on mental health – on May 5 at Hart House. She will talk about finding a psychotherapist who is a good match in terms of clinical approach but also cultural competence and affordability.

In advance of Mindfest, Sediqzadah spoke with writer Ben Gane from ��˾��ֱ��'s department of psychiatry about how those considering therapy can find a psychotherapist who is the right fit.

Why is finding a therapist who is a good match important?

Studies have shown that the success of psychotherapy has more to do with the therapeutic relationship between you and your psychotherapist than the type of psychotherapy you pursue. That’s the key and compelling reason.

What should you consider before starting your search for a therapist?

Ask yourself what brings you to psychotherapy: Are you seeking help for specific mental health symptoms such as anxiety or depressed mood, or for a specific mental health diagnosis? Are you seeking help for a situation in your life or life event (e.g., school or work-related stress, relationship issues, death of a loved one)? Do you want to explore the past or process past traumas? Or are you simply looking for an empathic listener (as you are lacking that in your life)?

Once you know what your needs or goals are, how can you decide if a potential therapist is equipped to help with them?

If you are searching for a registered psychotherapist, social worker, or a psychologist, they will often have a website or an online profile in a registry that can give you a feel of who they are, the type of psychotherapy they offer, what they might specialize in and elements of their background or identity that might resonate with you.

What if the first therapist you meet isn’t a good match?

Sometimes finding a therapist you feel safe and comfortable with requires meeting with a few therapists till you find the right fit.

Many private psychotherapists offer a free or discounted introductory session where you can get to know each other – you can ask them questions and discuss logistics including prices, scheduling, and location. “Shopping around” is not so easy if you need a medical doctor like a psychiatrist, as waitlists can be long.

What is “cultural competence,” and what role does it play in finding a therapist who’s a good match for you?

Cultural competence starts with challenging the assumption that our own cultural values are normal and anything outside of them is “other.” It’s important for us to recognize and check that assumption before we try to become competent in another person’s culture.

I consider cultural competence to be an interest and willingness to learn about another person’s cultural practices and worldview. It is openness, curiosity and a genuine wish to understand another culture to be better equipped to help others.

Cultural competence may or may not be important to you as you begin your search for a therapist. It is important to remember that while things are changing, psychotherapy continues to be a predominantly white, cis-heteronormative space in Toronto and North America. If you are a member of cultural, ethnic, racial and/or sexual minority, it may be difficult to find a therapist of a similar background – if that is important to you.

Are there tools to help find a therapist psychotherapist who shares your cultural identity?

I recommend searching registries for psychotherapists who self-identify as such or indicate experience or an interest in working with populations that you identify with. In Canada, I highly recommend Healing in Colour, a nationwide registry of psychotherapists who identify as Black, Indigenous and/or other people of colour (BIPOC) who support BIPOC populations and any of their intersecting identities including LGBTQIA2S+ and religion.

What are some barriers to accessing effective psychotherapy in Ontario that people may encounter?

Cost is probably the top barrier to accessing psychotherapy. In Ontario most psychotherapy providers are private, and depending on the client’s situation, paid for by private medical insurance or out of pocket. Only those with a medical degree (psychiatrists and family doctors who provide psychotherapy) are covered by OHIP. Unfortunately, almost anything in health care that is covered by OHIP will have a waitlist.

There are psychotherapists from a variety of different backgrounds who work at certain allied health organizations or not-for-profits that offer free psychotherapy. You can check out a list here. Once again, these will have long waitlists and are mostly time-limited.

Any other advice for those looking for a psychotherapist?

I’m glad they're prioritizing your mental health and seeking help from a professional – everyone can benefit from psychotherapy.

Visitors attend the 2022 Mindfest fair at Hart House (photo by Felix Chan)

'A creative perspective': Neurologist Suvendrini Lena on her path to playwriting

Christopher.Sorensen — Mon, 13 Mar 2023 21:12:38 +0000

'A creative perspective': Neurologist Suvendrini Lena on her path to playwriting

Christopher.Sorensen Mon, 03/13/2023 - 17:12

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Suvendrini Lena, an assistant professor in ��˾��ֱ��'s Temerty Faculty of Medicine, bridges the gap between medicine and theatre in her work as a playwright (photo courtesy of Suvendrini Lena)

Tabassum Siddiqui

Topic

City & Culture

Women's College Hospital

Suvendrini Lena has a foot in two worlds: she’s a staff neurologist at Women’s College Hospital and an assistant professor of neurology and psychiatry in the University of Toronto’s Temerty Faculty of Medicine – and a successful playwright.

After earning a B.A. in history and political science as an undergraduate student at Trinity College, Lena went on to a graduate degree in neurology at ��˾��ֱ�� – all while exploring her longstanding interest in theatre and writing.

But the path to writing her first play was a bit of a surprise – certainly to her neurology professors. Instead of presenting a final research project, she wrote a piece of theatre – The Enchanted Loom – that explored the experience of a patient with epilepsy. It was later produced by Toronto’s Cahoots Theatre and published as a book.

Since then, Lena has continued to work in both medicine and theatre – her latest play, Rubble, is currently on stage at Theatre Passe Muraille until March 18. A dramatic imagining of the works of Palestinian poets Mahmoud Darwish and Lena Khalaf Tuffaha, the play was inspired by Lena’s work in Gaza in 2002 while still a medical student. Years later, Tuffaha’s poetry reminded her of the struggles – and the rubble – she witnessed while there.

Including fellow ��˾��ֱ�� alumni Roula Said and Lara Arabian among the cast of five, Rubble unfolds in Gaza as a mother and her family receive a life-changing call: they have 58 seconds to leave their home before an explosion. Drawing on the poems of Darwish and Tuffaha, Lena examines the meaning of poetry amidst a state of siege.

Lena spoke to ��˾��ֱ�� News about how her university experience informed her path to bridging the gap between medicine and the arts.

You’re a neurologist by training but now also a playwright – how did you find your way from medicine to theatre?

I always wanted to be a writer. In the neurology program at ��˾��ֱ��, you have to do a big research project in your last year of the program, but I realized my heart wasn’t really in research. I’m definitely interested in understanding things well and the arts are another way to do that – you get to interrogate something, but from a creative perspective. I ended up writing a play about a Sri Lankan patient with a complex case of epilepsy and all the difficult choices facing him and his family as a result of his illness. So that became the centre of my first play.

What was your professors’ reaction when you asked to submit a play as your final project instead of a research paper?

There’s an art to pitching – it’s about taking an idea that has legs and having people understand and feel invested. So, I think I did that convincingly and I had open-minded supervisors – I was very lucky that way. I had great support and supervision, and we presented a reading from that play at the research presentation at the end of the year. The audience gave it a standing ovation. I think there was something compelling for them because they could see themselves depicted in a very human way. Doctors are so often portrayed in a one-dimensional way in TV and film, so I try not to do that myself.

What inspired you to write Rubble?

I’m a lover of poetry – especially these two particular poets; their lyrical poems exist on many levels. You have to hear it out loud to be able to appreciate the meaning – the poems also give you a window into the humanity of people who might feel distant from you, but you can see that’s not the case. I felt like it was a doorway to explore and give voice to the Palestinian experience – in the last 60 years, they have been displaced and under occupation, and there’s been very little clarity about that historical experience; very few places for them to really tell their story. So, the play is trying to create that space as well.

Lara Arabian in Rubble (photo courtesy of Theatre Passe Muraille/Aluna Theatre)

When you think back to your ��˾��ֱ�� studies, were there any mentors or faculty who made an impact on your educational and career path?

In my neurology program, Marika Hohol [Unity Health] and Richard Wennberg [University Health Network] were people I learned a lot from and who supported me. And during my undergrad years, I took courses in English and modern drama, including with an amazing professor, Alexander Leggatt – that’s really where my love of theatre was nurtured. He opened up the world of drama to many, many people. He was interested in ethics, philosophy and poetry – and really made it all accessible to us.

Left to right: Roula Said, Lara Arabian and Sam Khalilieh in Rubble (photo courtesy of Theatre Passe Muraille/Aluna Theatre)

How did your time at ��˾��ֱ�� help shape the work you do today?

I first studied history and political science, but got heavily into theatre when I directed plays with the Trinity College Dramatic Society. Afterwards, I swore I would never direct anything again – everything was so complicated! But I got to understand that when you study a text as a director, it’s a completely different experience than reading it in class, right? You step into building a theatrical world – which is what playwriting and theatre-making is all about.

How does your work as a doctor intersect with your work as a playwright?

In medicine, we deal with a lot of very difficult things all the time – and there's a bit of trauma in there. If you empathize with your patients, then you can’t help but witness suffering. These are very moving things and you’ve got to stay open and alive to all that. I need an outlet – writing provides me with that outlet and theatre is special because you can explore human issues and relationships in a unique way. All kinds of writing can touch on that, but when something is written for the theatre and embodied by an actor, it gives an added dimension of reality.

What’s your approach to teaching?

I mostly do small-group teaching in the medical school curriculum and a seminar on medicine and the humanities. This semester, we’re doing a staging where we explore medical experiences and how physicians examine their own subjectivity. We also try to engage with issues of contemporary relevance, including issues of voice and representation in medicine and society.

With a focus on mental health, ��˾��ֱ��’s Mindfest event aims to educate and inspire

Christopher.Sorensen — Mon, 28 Feb 2022 14:58:19 +0000

With a focus on mental health, ��˾��ֱ��’s Mindfest event aims to educate and inspire

Christopher.Sorensen Mon, 02/28/2022 - 09:58

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Nikhita Singhal, a resident physician in psychiatry at ��˾��ֱ��, is among the participants in this year's Mindfest event, which aims to build awareness about mental health and promote mental wellness (photo courtesy of Singhal)

Ben Gane

Topic

Mental Health

Mindfest

Temerty Faculty of Medicine staff

The University of Toronto will host its ninth annual Mindfest event in early March to build awareness of mental health and provide strategies to promote mental wellness.

This year’s event, which will take place virtually from March 5 to 8, provides a virtual venue for honest conversations about mental health, and features experts from ��˾��ֱ��’s department of psychiatry in the Temerty Faculty of Medicine, among others, in partnership with Jack.org.

The keynote speaker is sports broadcaster Michael Landsberg, who has experience with mood disorders and stigma. His organization, Sick Not Weak, has changed how Canadians think about mental illness and started new conversations about mental health in sports.

Psychiatry resident physician Chika Stacy Oriuwa will present about her experience as a Black woman in medicine, and how racial marginalization and mental health can intersect.

Associate Professors Daphne Korczak and Jennifer Crosbie will discuss impacts of the pandemic on the mental health of children and young people, and Kierston Drier will speak about self-care when resources are inaccessible from her perspective as founder of the Bathroom-Stall Project.

Mindfest amplifies unique perspectives on mental health.

Nikhita Singhal, also a resident physician in psychiatry at ��˾��ֱ��, will talk about how treatments for an eating disorder when she was a youth motivated her to pursue psychiatry as a career – and how those experiences have informed her approach to providing care.

Singhal was hospitalized for the first time at age eight and underwent a care program focused on weight gain and nutrition.

“It felt like a revolving door – a metaphor initially shared with me by a nurse who had worked on the unit for over a decade and repeatedly watched the same patients come in after being ‘weight-restored,’ then relapsing as soon as they left the hospital,” says Singhal. “I saw the same pattern for myself and many of my co-patients, as each encounter with the system pushed me further into illness and instilled a deep sense of distrust and frustration with treatment itself.”

Singhal says her experiences show that eating disorders are poorly understood, with treatments frequently centred on symptoms rather than underlying causes.

“I believe a greater focus on healing one’s relationship with the body and exploring the underlying issues would be beneficial,” says Singhal. “Current approaches often do include some element of therapy, yet the emphasis remains first and foremost on food and weight gain.”

The pandemic has seen a marked increase in the number of young people diagnosed with eating disorders, underlining the importance of identifying the most effective forms of treatment.

Singhal says tailoring treatments to the individual rather than taking a ‘one-size-fits-all’ approach would greatly benefit patients. As someone who has been both a patient and care provider, Singhal says we often divide these two groups into distinct categories and lose sight of their common humanity.

“Recognizing patients as the experts in their own experiences and appreciating the vast wealth of insight they bring to the table is crucial,” she says. “My hope is that we can bridge the gap between ‘us’ and ‘them’ in the health-care system – we are all human beings who may fall ill ourselves at some point, and this is not a weakness or flaw on our part.”

Singhal says people who want to help promote patient voices can openly discuss these topics with health-care providers and seek opportunities to add their voices to the conversation on a broader level.

The message reflects Mindfest’s core mission: include all voices in the mental health conversation. Singhal hopes her presentation will help others feel empowered, combat stigma and demonstrate what’s possible.

“We are not weak because we have struggled; the challenges we have faced and the experiences which have shaped our paths can make us stronger,” she says. “I believe there are multitudes of resilient, courageous individuals with their own stories to share who have a tremendous amount to offer to the health-care system.”

To beat depression, researchers hunt for perfect brain stimulation therapy 'rhythm'

Christopher.Sorensen — Wed, 26 Jan 2022 16:19:18 +0000

To beat depression, researchers hunt for perfect brain stimulation therapy 'rhythm'

Christopher.Sorensen Wed, 01/26/2022 - 11:19

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Researchers at work in the electrophysiology lab at Mount Sinai Hospital (photo by Colin Dewar/Sinai Health)

Topic

Breaking Research

Sinai Health

Centre for Addiction and Mental Health

Mental Health

Research & Innovation

When it comes to finding a long-lasting treatment for depression, a team of Toronto researchers says it could come down to finding the perfect rhythm.

The approach, under development by scientists at Sinai Health, the Centre for Addiction and Mental Health (CAMH) and the University of Toronto, has nothing to do with music and everything to do with tweaking an existing form of brain stimulation therapy.

To improve the technology and test it in patients, four researchers have today been awarded a grant by Bell Let’s Talk and Brain Canada.

Tarek Rajii

“It is a very exciting collaboration that combines bench and bedside research in the same project,” said Tarek Rajji, principal investigator and clinical lead on the project.

Rajji is executive director of the Toronto Dementia Research Alliance (TDRA) and chief of the adult neurodevelopment and geriatric psychiatry division at the Centre for Addiction and Mental Health (CAMH), as well as a Clinician Scientist in CAMH's Campbell Family Mental Health Research Institute. He is also a professor in the Temerty Faculty of Medicine’s department of psychiatry.

The research centres around transcranial magnetic stimulation, or TMS, a form of brain stimulation therapy that’s been shown to hold enormous promise in helping patients with treatment-resistant depression. The approach uses a device to deliver pulses of magnetic stimulation to the prefrontal cortex, a part of the brain associated with mood regulation.

The basic science component of the project involves brain stimulation to determine whether changing the spacing or tempo of the pulses to the brain could ultimately deliver long-lasting relief from depression symptoms.

Graham Collingridge

“The pattern of stimulation is vital,” said Graham Collingridge, a senior investigator at Lunenfeld-Tanenbaum Research Institute (LTRI) at Sinai Health and a professor of physiology and director of the Tanz Centre for Research in Neurodegenerative Diseases at Temerty Medicine. “It has been recently discovered that instead of applying the rhythm within a short space of time, [if] you have a break for a few minutes and then repeat the stimulation, the effect on synapses in the brain is stronger and longer-lasting.”

Collingridge studies a process called long-term potentiation, in which a brief period of intense neuronal activity leads to a long-lasting increase in the strength of connections between the nerve cells.

To find the perfect pattern, Rajji and Collingridge are collaborating with Evelyn Lambe, an associate professor of physiology at Temerty Medicine, who is leading the work to optimize the stimulus parameters in the prefrontal cortex, the region targeted by TMS in patients, as part of the Bell Let’s Talk Brain Canada research grant.

Evelyn Lambe

“The goal is to optimize treatment to rebuild connections between neurons essential for mood regulation,” said Lambe.

Her lab’s work investigating the impact of social isolation on the brain has become increasingly relevant to mental health during the COVID19 pandemic. “Social isolation and other stressors wear us down by impairing brain function at the cellular level,” Lambe notes.

Rajji, meanwhile, will adapt the optimized stimulation parameters to humans using TMS and electroencephalograhy. His team will examine which pattern of stimulation leads to better brain plasticity in the frontal lobes of adults with acute depression.

Sanjeev Sockalingam

Throughout the project, Sanjeev Sockalingam, a clinician-scientist and vice-president of education at CAMH, and professor of psychiatry at Temerty Medicine, will lead the knowledge translation component of the work. This will involve mental health clinicians, people with lived/living experience and families working with researchers from the start of the project.

“The integrated approach involving clinicians and service users will help us co-create knowledge that gets to people who can use it faster and more effectively,” said Sockalingam.

With files from Sinai Health, the Centre for Addiction and Mental Health and ��˾��ֱ��’s department of physiology.

Studies on risks versus benefits of antidepressant use during pregnancy should be clearer, ��˾��ֱ�� researchers say

Christopher.Sorensen — Mon, 15 Nov 2021 20:00:54 +0000

Studies on risks versus benefits of antidepressant use during pregnancy should be clearer, ��˾��ֱ�� researchers say

Christopher.Sorensen Mon, 11/15/2021 - 15:00

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(Photo by Natalia Deriabina/Getty Images)

Don Campbell

Topic

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Research & Innovation

��˾��ֱ�� Scarborough

Women's College Hospital

Those planning pregnancy are struggling to weigh the risks and benefits of antidepressant medication based on how research is currently presented, say researchers at the University of Toronto and Women’s College Hospital.

Hilary Brown, an assistant professor at the Dalla Lana School of Public Health, and Simone Vigod, a professor at the Institute of Health Policy, Management and Evaluation, say women need greater clarity on antidepressant use during pregnancy because they are making decisions based on the results of studies that focus on a single outcome (like preterm birth, child autism or academic outcomes).

Brown and Vigod say these studies often overlook the benefits of antidepressant medication and don't make it clear that negative outcomes are often very rare.

“When these studies come out, it’s really difficult for mothers to figure out what to do,” says Brown, who is also an assistant professor in the department of health and society at ��˾��ֱ�� Scarborough.

“If they see a headline or something on social media about a particular outcome found in one individual study, it can affect their decision on taking medication they may really need.”

In an editorial in the Journal of the American Medical Association, Brown and Vigod make the case for a more personalized approach to research that weighs the risks and benefits of taking antidepressants so women can make a decision that is right for them. The researchers say this would also help doctors make more informed recommendations on treatment options.

“The way the research is set up right now, it doesn’t let us take this personalized approach,” says Vigod, who is also a professor in ��˾��ֱ��’s department of psychiatry and psychiatrist-in-chief and senior scientist at Women's College Hospital.

Instead of the current single-outcome studies, they say research should be done using novel approaches that have been applied in broader antidepressant research. This includes looking at all of the risks and benefits for antidepressant medications at the same time, and also examining how patient characteristics can affect the balance of these risks and benefits.

Vigod and Brown's editorial was published in the same issue as a study that investigated a link between maternal antidepressant use and the math and literacy standardized test scores of Danish children. The study found no statistically significant difference in literacy scores, but it recorded a small yet statistically significant difference of negative 2.2 points (out of 100) on math scores – after accounting for other differences between mothers who did and did not take antidepressants.

Brown and Vigod say the study's authors were cautious in wording their conclusions, but that the results of these types of studies often get blown out of proportion when they hit the news and are shared on social media.

“It’s difficult for many people to interpret this, especially when the headlines run with the message of a ‘significant difference’ as opposed to the broader picture, which is that these effects are still tiny,” Brown says.

The stakes of re-aligning research priorities and getting the right information to patients couldn’t be higher.

Brown says untreated depression is itself a risk factor for negative childhood outcomes. Depression is a common complication of pregnancy, estimated to affect 9.2 per cent of pregnant women in high-income countries. Studies have shown that untreated depression can influence rates of accessing prenatal care, preterm birth, and developmental delay, among other things.

“That’s a major reason why decision-making in this area is so important,” she says. “There are very real consequences to a mother and child’s well-being that comes with untreated depression.”

Listening to favourite music improves brain function in Alzheimer’s patients: ��˾��ֱ�� research

Christopher.Sorensen — Wed, 10 Nov 2021 19:36:22 +0000

Listening to favourite music improves brain function in Alzheimer’s patients: ��˾��ֱ�� research

Christopher.Sorensen Wed, 11/10/2021 - 14:36

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(Photo by Ron Lech/Pexels)

Josslyn Johnstone

Topic

Breaking Research

Faculty of Music

St. Michael's Hospital

Repeated listening to personally meaningful music induces beneficial brain plasticity in patients with mild cognitive impairment or early Alzheimer’s disease, a new study by researchers at the University of Toronto and Unity Health Toronto suggests.

Changes in the brain’s neural pathways correlated with increased memory performance on neuropsychological tests, supporting the clinical potential of personalized, music-based interventions for people with dementia.

The multi-modal study was published this week in the Journal of Alzheimer’s Disease.

“We have new brain-based evidence that autobiographically salient music – that is, music that holds special meaning for a person, like the song they danced to at their wedding – stimulates neural connectivity in ways that help maintain higher levels of functioning,” says Michael Thaut, senior author of the study, director of ��˾��ֱ��’s Music and Health Science Research Collaboratory and a professor in both the Faculty of Music and Temerty Faculty of Medicine.

“Typically, it’s very difficult to show positive brain changes in Alzheimer’s patients. These preliminary yet encouraging results show improvement in the integrity of the brain, opening the door to further research on therapeutic applications of music for people with dementia – musicians and non-musicians alike,” says Thaut, who also holds the tier one Canada Research Chair in Music, Neuroscience and Health.

The researchers reported structural and functional changes in neural pathways of study participants, notably in the prefrontal cortex, the brain’s control centre where deep cognitive processes occur. The researchers showed that exposing the brains of patients with early-stage cognitive decline to autobiographically salient music activated a distinct neural network – a musical network – composed of diverse brain regions that showed differences in activation after a period of daily music listening.

They also observed differences in the brain’s connections and white matter, providing further evidence of neuroplasticity.

“Music-based interventions may be a feasible, cost-effective and readily accessible intervention for those in early-stage cognitive decline,” says Corinne Fischer, lead author, associate professor in the department of psychiatry in the Temerty Faculty of Medicine, and director of geriatric psychiatry at St. Michael’s Hospital, Unity Health Toronto.

“Existing treatments for Alzheimer’s disease have shown limited benefit to date,” she adds. “While larger controlled studies are required to confirm clinical benefits, our findings show that an individualized and home-based approach to music-listening may be beneficial and have lasting effects on the brain.”

For the study, 14 participants – eight non-musicians and six musicians – listened to a curated playlist of autobiographically relevant, long-familiar music for one hour a day over the course of three weeks. Participants underwent structural and task-based functional MRI before and after the listening period to determine changes to brain function and structure. During these scans, they listened to clips of both long-known and new music. Heard one hour before scanning, the new music was similar in style and yet held no personal meaning for the listeners.

When participants listened to the new music, brain activity occurred mainly in the auditory cortex. However, when participants listened to long-known music, there was significant activation in the deep-encoded network of the prefrontal cortex, a clear indication of executive cognitive engagement.

There was also strong engagement in subcortical brain regions, older areas minimally affected by Alzheimer’s disease pathology.

The researchers reported subtle but distinct differences in structural and functional brain changes associated with music listening in musicians relative to non-musicians, though further studies in larger samples are needed to verify these findings. Repeated exposure to music with autobiographical salience improved cognition in all participants, regardless of musicianship.

“Whether you’re a lifelong musician or have never even played an instrument, music is an access key to your memory, your pre-frontal cortex,” Thaut says. “It’s simple: keep listening to the music that you’ve loved all your life. Your all-time favourite songs, those pieces that are especially meaningful to you. Make that your brain gym.”

The ��˾��ֱ��-Unity Health study builds on previous work with the same participant group that first identified the brain mechanisms that encode and preserve musical memories in people with early-stage cognitive decline.

Next, the researchers plan to replicate the study in a larger sample and institute a strong control condition to investigate the role of musicianship in moderating brain responses, and whether it is the music or the autobiographical content that induces changes in plasticity.

��˾��ֱ��’s Kenneth Fung on the impact of anti-Asian racism on mental health

rahul.kalvapalle — Thu, 20 May 2021 19:30:06 +0000

��˾��ֱ��’s Kenneth Fung on the impact of anti-Asian racism on mental health

rahul.kalvapalle Thu, 05/20/2021 - 15:30

Cutline

(Steve Russell/Toronto Star via Getty Images)

Rahul Kalvapalle

Topic

Princess Margaret Cancer Centre

Anti-Asian Racism

Mental Health

University Health Network

Kenneth Fung

With anti-Asian racism on the rise in Canada, concerns are mounting over the impact on people’s mental health.

That’s why University of Toronto psychiatrist Kenneth Fung says it’s important to couple the fight against Anti-Asian racism with efforts to build resilience in individuals and communities – and foster culturally competent mental health services.

On May 22, Fung, an associate professor in the department of psychiatry in ��˾��ֱ��’s Temerty Faculty of Medicine and clinical director of the Asian Initiative in Mental Health at the University Health Network (UHN), will discuss the topic during a workshop and panel discussion titled “Anti-Asian Racism: Addressing the Mental Health Impact of Racism.”

The first in a three-part series on resilience, the webinar is hosted by the Asian Initiative in Mental Health.

Fung will joined by Fei-Fei Liu, chief of the radiation medicine program at Princess Margaret Cancer Centre and professor in the department of radiation oncology in the Temerty Faculty of Medicine; Janice Fukakusa, chancellor of Ryerson University and chair of the board of directors of the Princess Margaret Cancer Foundation; and Jenny Liu, a post-doctoral researcher at UHN and lecturer at Ryerson.

Ahead of the webinar, which will feature interpretation in Cantonese and Mandarin, ��˾��ֱ�� News spoke with Fung about anti-Asian racism, the impact of discrimination on mental health and how individuals and groups can tackle racism and build resilience.

How has the COVID-19 pandemic fueled or influenced anti-Asian racism in Canada?

There has been a long-standing history of anti-Asian racism since the founding of the nation. Since COVID-19, we are now seeing brazen physical and verbal attacks that blame Asians for bringing in the virus and people acting as if Asians the source of contagion. We also see negative portrayals of Asians and suggestions that maybe it’s their bad habits that created the virus.

Insults like “go home” are pretty obviously damaging and un-Canadian, if you will, because when you ask someone to go home, you’re saying that Canada isn’t welcoming you here and isn’t considered your home. This is something that is being said to people who have been here for generations and are just as Canadian as any other Canadian.

There’s also the pre-existing myths of the “model minority” and of Asian-Canadians taking away everyone’s jobs and being so well-off. In fact, there’s just as much diversity and spectrum within the Asian-Canadian population as other Canadian populations. We know from pre-existing data that Chinese Canadians, for example, have more limited access to mental health care.

In addition, if you compare immigrants or visible minorities, they often – as a group – earn less and are more likely to be under-employed for their training and equivalent status. There are all kinds of studies showing that they’re less likely to be promoted in corporate settings, and more likely to be precariously employed.

So, systemic racism is taking a toll on the Asian population on top of the overt verbal insults and violent assaults. There’s cause for concern that all this has risen in the context of the pandemic.

How do acts of racism affect the mental health of victims and communities?

There is a very direct impact from racist attacks and comments. It can be a very traumatic experience to be accosted and assaulted. All of this can have a psychological – even physical, in some cases – impact on the individual.

It can also psychologically make Asians feel like this is not their home – so you don’t feel like you have a Canadian identity. This has direct implications for mental health and psychological well-being.

One Ontario study showed that the Chinese-Canadian population has one of the lowest expressed senses of self and belonging in Canada. I think that’s likely related to Chinese Canadians also having one of the poorest self-rated mental health. Racism just increases all of this by decreasing the sense of belonging and well-being.

Of course, there are also other indirect impacts that include the social determinants of health, such as finding it more difficult to get a job because of your credentials not being recognized or maybe because of language skills or an accent. Even if Asian Canadians have been here for generations, speak the language and are educated here, there’s still a disparity that can be seen in terms of employment, under-employment and promotions. All of that has an impact on mental health.

That’s why we’re seeing impacts on the individual level, family level as well as the community level for the entire Asian-Canadian population.

How can the mental health impacts of racism be addressed in a culturally sensitive manner?

When people’s mental and physical health and well-being are under attack in the context of a racist environment, a lack of culturally appropriate services means that people who are also suffering from racism are less likely to reach out for help.

Secondly, in the Asian context, a lack of acknowledgement of racism can lead to internalized racism – especially given the myth of the model minority. This means people’s experiences with racist attacks may be invalidated, minimized or not understood in their appropriate cultural context. This leads to people internalizing racism or feeling shy to stand up to racism. They may feel like, “Oh, we hear about the Black Lives Matter movement and that group has it worse so we don’t have a right to complain.” It’s often a part of Asian culture to build harmony, which can make people reluctant to come forward.

The myth of the model minority can sometimes be used to pit one group against another group rather than striving for equity for everyone. This means the impact of racism can be worse and the capacity for people to speak up, feel validated and get help is worse. We need to dispel the myth of the model minority and address the impact of people internalizing racism.

A culturally sensitive and competent approach is needed to understand both the history and the context in which these acts of racism occur, as well as to understand the impact of the racism and address it.

What does it mean to build resilience, and how can this mitigate the mental health impacts of racism?

Resilience is very important. Whether you have a diagnosis mental illness or not, everyone can benefit from attention to resilience as a way to promote well-being.

People often define resilience as coming back from adversity, which I think is important – the ability to bounce back. We need to be able to bounce back from difficulties, whether it’s the pandemic or racism. Building resilience, then, is important so that when you encounter adversity you have the enhanced capacity to bounce back.

However, one potential flaw with talking about resilience in this way is that you might be tempted to mistakenly say that being resilient means not caring about racism attacks. Resilience isn’t just about an individual’s capacity to bounce back, but about recognizing that resilience is sourced from both internal and external resources. That means your actual resilience is partly determined by your external environment, which includes culturally competent and accessible services, and includes a feeling of security and belonging to your community.

In the case of racism, we need to internally acknowledge and recognize that racism has a direct psychological impact and we need to be equipped to heal from the trauma and not internalize racism. All of that is important to strengthen internal resilience and acknowledge that if you do feel stress, it doesn’t mean that you’re weak. But external collective resilience also needs to be there from friends, family, communities and getting involved to advocate for services and collectively stand up against racism.

Individually, people can feel pretty powerless against systemic racism. But as a collective, both within the Asian community and with the Canadian community at large, we can all work together to strive towards an equitable and just society.

��˾��ֱ��'s Mindfest event to explore diversity and the impact of COVID-19 on mental health

Christopher.Sorensen — Wed, 03 Mar 2021 16:18:15 +0000

��˾��ֱ��'s Mindfest event to explore diversity and the impact of COVID-19 on mental health

Christopher.Sorensen Wed, 03/03/2021 - 11:18

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(Photos courtesy of Kenneth Fung and Lisa Andermann)

Ben Gane

Topic