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21 results

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  • Evaluating the benefits of a youth mental health curriculum for students in Nicaragua: a parallel-group, controlled pilot investigation

  • Arun V. Ravindran, Andres Herrera, Tricia L. da Silva, Joanna Henderson, Magda Esther Castrillo, Stan Kutcher
  • Journal:
    Global Mental Health / Volume 5 / 2018
    Published online by Cambridge University Press:
    25 January 2018, e4
    • Article
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  • Background.

    High rates of mental illness and addictions are well documented among youth in Nicaragua. Limited mental health services, poor mental health knowledge and stigma reduce help-seeking. The Mental Health Curriculum (MHC) is a Canadian school-based program that has shown a positive impact on such contributing factors. This pilot project evaluated the impact of the MHC on mental wellness and functioning among youth in Leon, Nicaragua.

    Methods.

    High school and university students (aged 14–25 years) were assigned to intervention (12-week MHC; n  =  567) and control (wait-list; n  =  346) groups in a non-randomized design. Both groups completed measures of mental health knowledge, stigma and function at baseline and 12 weeks. Multivariate analyses and repeated measures analyses were used to compare group outcomes.

    Results.

    At baseline, intervention students showed higher substance use (mean difference [MD]  =  0.24) and lower perceived stress (MD = −1.36) than controls (p  <  0.05); there were no other group differences in function. At 12 weeks, controlling for baseline differences, intervention students reported significantly higher mental health knowledge (MD  =  1.75), lower stigma (MD  =  1.78), more adaptive coping (MD  =  0.82), better lifestyle choices (MD  =  0.06) and lower perceived stress (MD = −1.63) (p  <  0.05) than controls. The clinical significance as measured by effect sizes was moderate for mental health knowledge, small to moderate for stigma and modest for the other variables. Substance use also decreased among intervention students to similar levels as controls (MD  =  0.03) (p > 0.05).

    Conclusions.

    This pilot investigation demonstrates the benefits of the MHC in a low-and-middle-income youth population. The findings replicate results found in Canadian student populations and support its cross-cultural applicability.

School Mental Health
  • Global Challenges and Opportunities
  • Edited by Stan Kutcher, Yifeng Wei, Mark D. Weist
  • Published online:
    05 May 2015
    Print publication:
    05 May 2015
  • The realisation that most mental disorders have their onset before the age of twenty-five has focused psychiatric research towards adolescent mental health. This book provides vivid examples of school mental health innovations from eighteen countries, addressing mental health promotion and interventions. These initiatives and innovations enable readers from different regions and disciplines to apply strategies to help students achieve and maintain mental health, enhance their learning outcomes and access services, worldwide. Through case studies of existing programs, such as the integrated system of care approach in the USA, the school-based pathway to care framework in Canada, the therapeutic school consultation approach in Turkey and the REACH model in Singapore, it highlights challenges and solutions to building initiatives, even when resources are scarce. This will be essential reading for educators, health providers, policy makers, researchers and other stakeholders engaged in helping students achieve mental health and enhance their learning outcomes.

Practical Child and Adolescent Psychopharmacology
  • Edited by Stan Kutcher
  • Published online:
    31 August 2009
    Print publication:
    18 April 2002
  • The field of child and adolescent psychopharmacology is rapidly growing, but psychopharmacological treatments for children cannot be straightforwardly extrapolated from adult studies, which presents clinicians with assessment and prescribing challenges. This important book synthesises research findings about drug treatment of a broad range of psychiatric disorders in children, including attention-deficit hyperactivity disorder, obsessive-compulsive disorder, major depression, schizophrenia, bipolar mania, aggression in pervasive developmental disorder, Tourette's syndrome and substance abuse. They examine the issues of tolerability and efficacy, and appropriate use, within a social and developmental context. For each disorder, pharmacotherapy is discussed in the wider context of neurobiology, etiology, diagnosis and treatment. This will be essential reading for all mental health professionals to inform practice and improve patient outcomes.

  • Postgraduate psychiatry training for global mental health: a Canadian experience

  • Sonia Chehil, Stan Kutcher
  • Journal:
    International Psychiatry / Volume 1 / Issue 5 / July 2004
    Published online by Cambridge University Press:
    02 January 2018, pp. 16-18
    Print publication:
    July 2004
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  • As globalisation has diminished the distance between the developed and developing worlds, it has highlighted the impact of global health issues on domestic health concerns and has underscored the reality of global health disparities. In the Canadian context, there is a need for Canadian physicians to have an understanding of medicine from a global perspective and to appreciate and understand the impact of global health issues on both international and domestic health care. Consequently, there is a need to create and incorporate a global or international health curriculum into general as well as specialty physician training programmes. This will provide future physicians with the skills, knowledge and understanding necessary to provide globally informed practice in domestic as well as international health.

  • 2 - Developmental psychopharmacology

  • Edited by Stan Kutcher, Dalhousie University, Nova Scotia
  • Book:
    Practical Child and Adolescent Psychopharmacology
    Published online:
    31 August 2009
    Print publication:
    18 April 2002, pp 38-69

  • Summary

    This chapter reviews the normal development of central nervous system (CNS), developmental aspects of neurotransmitters and receptors, developmental neuroimaging, and experimental studies involving psychotropic compounds in young animals. The complementary concepts of brain plasticity and sensitive periods are two important frameworks which inform many aspects of brain development. It is known that neurotransmitters and receptors are expressed at their highest levels in the immature brain and in anatomic regions different than in the mature brain, even in the absence of fully functional synapses. Investigators have hypothesized that stressful experiences during development may have a long-term effect on hippocampus by directly altering its structure and functioning. Two areas of research that are of immediate application in the child and adolescent age group are the theory of genetic anticipation and the identification of candidate genes in ADHD.

  • Preface and acknowledgements

  • Edited by Stan Kutcher, Dalhousie University, Nova Scotia
  • Book:
    Practical Child and Adolescent Psychopharmacology
    Published online:
    31 August 2009
    Print publication:
    18 April 2002, pp xiii-xiv

  • Summary

    The field of child and adolescent psychopharmacology is rapidly growing and every clinician, physician, and other health provider alike must be informed of new directions and applications in the use of medications as they pertain to the treatment of psychiatric disorders in children and adolescents. To date, considerable research has been conducted which can properly direct the use of a variety of psychotropic compounds in a number of child and adolescent psychiatric disorders. In particular, well-established and effective pharmacologic treatments are available for attention-deficit hyperactivity disorder, obsessive-compulsive disorder, and Tourette's syndrome. Less well-established but nonetheless frequently applied pharmacotherapies are used to treat a variety of psychiatric illness (such as major depression, schizophrenia, bipolar mania) or specific symptoms which may occur independently or as a component of a particular psychiatric diagnosis – such as aggression in pervasive developmental disorder.

    Evidence and experience to date clearly indicates that psychopharmacologic treatments for children and teenagers cannot be extrapolated from studies conducted in adult patients. Young people have a different central nervous system development, exhibit different cognitive, behavioral, and affective “norms” and are exposed to different environmental influences. All of these factors can influence the response to pharmacologic treatments – efficacy as well as tolerability. Thus, the study and practice of pharmacologic treatments of child and adolescent psychiatric disorders must become a special and significant area in its own right.

  • 9 - Adolescent depression: neuroendocrine aspects

  • Edited by Ian M. Goodyer, University of Cambridge
  • Book:
    The Depressed Child and Adolescent
    Published online:
    18 December 2009
    Print publication:
    11 January 2001, pp 233-266

  • Summary

    Neuroendocrine studies of adolescent depression are still in their early formative years. This chapter reviews the current literature on various neuroendocrine studies in adolescent depression. It summarizes relevant physiological information about various endocrine systems and succinctly reviews selected adult findings in similar areas of investigation to highlight similarities and differences to adolescent studies in findings where they occur. Growth hormone (GH) release from the pituitary is regulated by the interplay of the neurotransmitters, either by direct hypothalamic action or through their effect on intermediate compounds such as growth hormone-releasing hormone (GHRH) or somatostatin. The hypothalamic-pituitary-growth hormone (HPGH) axis provides a good model for evaluating CNS functioning. Studies of adult depressives have shown blunted ACTH responses to CRH regardless of serum cortisol levels. Neurotransmitter regulation of melatonin secretion is complicated and not fully understood. Further research into the multiple aspects of serotonergic functioning should be a priority in future development.

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