Impulsivity is an important risk factor for suicide and therefore, identifying biomarkers associated with impulsivity could be important in evaluating psychiatric patients. Currently, assessment of impulsivity is based solely on clinical evaluation. In this study, brain-derived neurotrophic factor (BDNF), a nerve growth factor, was evaluated as a potential biomarker for impulsivity. We hypothesize that elevated BDNF may result in aberrantly high neurobiological activation, promoting impulsive behaviours. A total of 343 participants were recruited for the study and were divided into two groups, (i) elevated suicide risk (participants admitted to hospital with a recent suicide attempt), and (ii) average suicide risk (non-psychiatric participants and psychiatric participants without a history of suicide attempts). Impulsivity was measured by the Barratt Impulsiveness Scale, and serum BDNF levels were obtained. A regression analysis was performed to identify associations between BDNF and impulsivity. We identified a subtle but significant positive association between BDNF and impulsivity in the average risk for suicide group (B = 0.189, p = 0.014). The same association was not reproduced in the elevated risk group B = −0.086, p = 0.361). These findings lay the foundation to further explore the utility of BDNF as a biomarker for impulsivity to allow for early intervention.

Background:The accuracy and completeness of Mental Health Act forms applied to involuntary patients in an inpatient unit is of paramount importance not only for legal but also for patient safety reasons within a hospital. Materials and methods: This was a retrospective study of 250 patient charts from January 1, 2014 to March 31, 2014. Results: Chart review provided a total of 224 Form 3, 4, 30, and 33 certificates with an overall error rate of 13.19% completion. Of those physicians who completed these certificates, the error rate was 11.63% if a resident physician were to complete and 19.23% if a staff physician were to apply the form. Conclusion: As physicians, there is a legal and moral responsibility to ensure the accuracy of such documentation both ethically and practically as well as a responsibility to the patient and their rights under the Mental Health Act.

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Background Brain-derived neurotrophic factor (BDNF) has been a focus of psychiatric research for the past two decades. BDNF has been shown to impact neural function and development. Studies have investigated serum BDNF as a biomarker for psychiatric disorders such as depression and schizophrenia. In some studies, investigators attempt to control for variables such as smoking status, exercise, or diet. However, the relationship between these factors and BDNF is not clearly established. Furthermore, some studies have questioned whether a difference in the impact of BDNF exists between psychiatric and healthy populations. Purpose We aim to examine the association between serum BDNF levels and modifiable risk factors such as body mass index (BMI), smoking, exercise levels, and diet. Subsequently, we aim to examine whether the relationship between these risk factors and serum BDNF is different between psychiatric and control populations. Patients and Methods We use cross-sectional data from an age- and sex-matched case–control study of participants with psychiatric inpatients and community controls without psychiatric diagnoses. Participants completed comprehensive assessments at study enrolment including sociodemographic information, smoking status, exercise, diet, and BMI. Serum BDNF levels were collected from participants. Linear regression analysis was performed to determine the association between modifiable factors and serum BDNF level. Results A significant association was found between sedentary activity level and lower serum BDNF levels (Beta coefficient = –2.49, 95% confidence interval [CI] –4.70, –0.28, p = 0.028). Subgroup analysis demonstrated that this association held for psychiatric inpatients but not for community controls; it also held in females (Beta coefficient = –3.18, 95% CI –6.29, –0.07, p = 0.045) but not in males (Beta coefficient = –1.42, 95% CI –4.61, 1.78, p = 0.383). Antidepressant use had a significantly different association between male (Beta coefficient = 3.20, 95% CI 0.51, 5.88, p = 0.020) and female subgroups (Beta coefficient = –3.10, 95% CI –5.75, –0.46, p = 0.022). No significant association was found between other factors and serum BDNF. Conclusion Sedentary activity level may lead to lower serum BDNF levels in individuals with psychiatric diagnoses. Our findings support the notion that physical activity can provide a positive impact as part of treatment for psychiatric illness.

AimsMental illness is among the leading causes of disability globally, however the treatment gap is wide even for developed countries. The perspectives of patients and mental healthcare providers are critical to understanding barriers to adequate mental healthcare and developing scalable solutions that improve access and quality of services. However, the views of providers are relatively understudied, precipitating our review to collate and synthesize their perspectives on the barriers to mental healthcare in Canada.MethodsWe searched MEDLINE/PubMed and PsychINFO for studies with findings in Canada published in English from 2000–2021 with terms for mental health, psychiatry, barriers, and referrals. Included studies were evaluated with the National Institutes of Health Study Quality Assessment Tools and Critical Appraisal Skills Programme.Results631 papers were screened, finding 20 eligible studies, including 13 qualitative, one cross-sectional, one retrospective, and five mixed-methods studies. Through inductive content analysis, five themes of barriers emerged: (1) patient accessibility (19% of studies), (2) health systems availability and complexity (31%), (3) training/education (25%), (4) work conditions (21%), and (5) cultural sensitivity (4%). Among barriers discussed, common challenges included a lack of resources for both patients and providers, gaps in continuing education for primary care providers, and health systems challenges such as difficulty securing referrals, unclear intake criteria, and confusion due to overload of contacts.ConclusionHealth systems face a multi-faceted set of challenges to improving access to mental healthcare that will require solutions from various stakeholders. Understanding these barriers is critical in focusing initiatives to improve mental health care, both in Canada and in countries facing similar challenges.