Publications by authors named "Philip G Tibbo"

Article Synopsis
  • Several trials have shown that adversity-focused treatments can reduce symptoms of PTSD and psychosis, but there is limited research on their effects on substance use, especially in early phase psychosis populations.
  • This study tested an adapted prolonged exposure therapy (PE+) on 19 adults with psychotic disorders and substance misuse, assessing multiple outcomes before and after treatment.
  • Results indicated significant improvements in some adversity-related areas and participant satisfaction, but there was no overall improvement in psychotic symptoms and substance misuse actually increased for some individuals.
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Background: Cannabidiol (CBD) impacts brain regions implicated in anxiety reactivity and stress reactivity (e.g., amygdala, anterior cingulate cortex (ACC), anterior insula (AI)); however, placebo-controlled studies are mixed regarding CBD's anxiolytic effects.

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Article Synopsis
  • Psychotic-like experiences (PLEs) are common in kids and teens and can lead to serious mental health problems later on.
  • A study of 16,560 young people found that about 17.3% had PLEs, which were linked to a higher risk of developing a psychotic disorder in early adulthood.
  • The way PLEs are assessed matters; interviews might be better at identifying those at risk for psychosis compared to self-reports, and more research is needed to understand how PLEs and other factors interact.
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Using electroencephalography (EEG) to examine the simple mismatch negativity (MMN), a marker of auditory cortex function, has been of great interest in the exploration of biomarkers for psychotic illness. Despite many studies reporting MMN deficits in chronic schizophrenia, there are inconsistent reports of MMN reductions in the early phases of psychotic illness, suggesting the MMN elicited by traditional paradigms may not be a sensitive enough measure of vulnerability to be used as a biomarker. Recently, a more computationally complex measure of auditory cortex function (the complex mismatch negativity; cMMN) has been hypothesized to provide a more sensitive marker of illness vulnerability.

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Over the past decade, there has been extensive research on the mismatch negativity (MMN) and its promise as a biomarker of illness in people with schizophrenia (SZ). Nevertheless, when attempting to assess the early stages of illness progression, the utility of MMN has been inconsistent. Recently, researchers have been investigating a more advanced MMN paradigm (the complex MMN [cMMN]) which is believed to index higher-order cognitive processing and has been suggested to be a more effective indicator of the early phases of SZ.

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Article Synopsis
  • - The study investigates how early experiences of help-seeking affect young adults' perceptions and engagement in early intervention services (EIS) for psychosis, focusing on those entering through inpatient or emergency departments.
  • - Twelve young adults were interviewed about their initial help-seeking experiences, resulting in three main themes: navigating healthcare, the importance of dignity, and the impact of their referral experiences on their views of EIS.
  • - Findings suggest that negative healthcare encounters can lead to distrust and reduced engagement in treatment; thus, it's crucial for EIS to prioritize patients' dignity and allow them to reflect on past negative experiences to improve their involvement in care.
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Article Synopsis
  • PTSD and cannabis use disorder (CUD) often occur together, possibly due to learned associations between trauma cues and the desire for relief through cannabis.
  • A study involving 202 participants explored the effects of writing about traumatic versus neutral topics on feelings and cravings related to cannabis, revealing notable differences in emotional responses and craving levels based on the type of writing and PTSD status.
  • The findings suggest that online expressive writing can be an effective tool for addressing negative emotions and cravings in individuals with PTSD and CUD, offering potential strategies for prevention and treatment.
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Background: Cannabis use may be a modifiable risk factor for mental health problems; however, the role of cannabis use frequency in population seeking mental health and addiction services remains unclear. This study aimed to: 1) compare the prevalence and functional impact of psychiatric symptoms among frequent, infrequent, and non-users of cannabis; and 2) evaluate the associations between cannabis use frequency and functional impact of psychiatric symptoms in help-seeking individuals.

Methods: Data from the Mental Health and Addictions (MHA) Central Intake system in Nova Scotia, Canada was used.

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This study examined the relationship between terminal referral source and subsequent urgent health service use in a Canadian early intervention service (EIS) for psychosis. Administrative health record data of emergency and inpatient mental health service use over a 2-year follow up from entry to EIS were retrospectively analyzed (n = 515). Negative binomial regression models were used to assess for the relationship between referral source and care outcomes.

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Background: Distributed Medical Education (DME), a decentralized model focused on smaller cities and communities, has been implemented worldwide to bridge the gap in psychiatric education. Faculty engagement in teaching activities such as clinical teaching, supervision, and examinations is a crucial aspect of DME sites. Implementing or expanding DME sites requires careful consideration to identify enablers that contribute to success and barriers that need to be addressed.

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Many Canadian emerging adults (ages 18-25 years) use cannabis, with 60 % of past-three-month users experiencing one or more cannabis-related problems (i.e., adverse consequences of use).

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The use of long-acting injectable (LAI) antipsychotic drugs for psychotic disorders in Canada has been historically low compared to other jurisdictions despite advantages of LAIs in improving medication adherence and preventing relapse. In response, treatment recommendations were developed in 2013 by the Canadian Consortium for Early Intervention in Psychosis and other Canadian provincial expert groups. The impact of these guidelines needed to be assessed.

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Cannabis use is increasingly normalized; psychosis is a major adverse health outcome. We reviewed evidence on cannabis use-related risk factors for psychosis outcomes at different stages toward recommendations for risk reduction by individuals involved in cannabis use. We searched primary databases for pertinent literature/data 2016 onward, principally relying on reviews and high-quality studies which were narratively summarized and quality-graded; recommendations were developed by international expert consensus.

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We have previously reviewed the types and numbers of cannabis-associated adverse events that have mental health presentations that are encountered in the Emergency Department. A particular challenge in examining these events is disentangling cannabis use adverse events from adverse events associated with use of multiple recreational substances. Since that review was published, cannabis legalization for recreational use has greatly expanded world-wide and with these changes in the legal climate has come clearer information around the frequency of adverse events seen in the Emergency Department.

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Innovative technology-based solutions have the potential to improve access to clinically proven interventions for cannabis use disorder (CUD) in individuals with first episode psychosis (FEP). High patient engagement with app-based interventions is critical for achieving optimal outcomes. 104 individuals 18 to 35 years old with FEP and CUD from three Canadian provinces completed an electronic survey to evaluate preferences for online psychological intervention intensity, participation autonomy, feedback related to cannabis use, and technology platforms and app functionalities.

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Objective: Cannabis is commonly used by Canadian emerging adults (ages 18-25 years), many of whom attend post-secondary institutions. Frequent cannabis use is linked with psychotic-like experiences (PLEs); however, the exact nature of this association remains unclear. Anxiety symptoms may mediate this association, as they are prevalent in emerging adults and have been independently linked with both cannabis use and PLEs.

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Background: MMN and P3a are EEG-derived event related potentials that are thought to be prospective biomarkers for schizophrenia and, potentially, early-phase psychosis (EPP).

Methods: EPP (n = 12) and healthy control (HC; n = 35) participants listened to a multi-feature optimal paradigm with five deviant types (gap, duration, location, intensity, and frequency).

Results: There was a significant amplitude difference between the EPP and HC group with duration MMN (p = .

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Glutamatergic dysfunction is implicated in schizophrenia pathoaetiology, but this may vary in extent between patients. It is unclear whether inter-individual variability in glutamate is greater in schizophrenia than the general population. We conducted meta-analyses to assess (1) variability of glutamate measures in patients relative to controls (log coefficient of variation ratio: CVR); (2) standardised mean differences (SMD) using Hedges g; (3) modal distribution of individual-level glutamate data (Hartigan's unimodality dip test).

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Background: Adversity is prevalent among people with psychotic disorders, especially those within the first 5 years of a psychotic disorder, called early phase psychosis. Although adversity can lead to many negative outcomes (e.g.

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Article Synopsis
  • Cannabis use among adolescents and young adults is linked to cannabis use disorder (CUD) and psychosis, with high cases of CUD found in individuals experiencing first-episode psychosis (FEP).
  • Early Intervention Services (EIS) aim to address CUD through psychosocial methods, but barriers like limited access can impede their effectiveness, prompting interest in mobile health (mHealth) solutions.
  • This study outlines a pilot trial for a new mHealth intervention called iCanChange (iCC) aimed at reducing CUD in young adults with FEP, combining techniques like cognitive behavioral therapy and motivational interviewing over a 12-week program.
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Article Synopsis
  • The study analyzed mismatched negativity (MMN) and P3a waveforms in individuals with early-phase psychosis (EPP) and healthy controls to explore their potential as schizophrenia biomarkers.
  • Both waveforms did not show significant differences in amplitude between groups; however, negative symptoms like asociality and blunted affect correlated with reduced MMN and P3a.
  • Findings indicate that instead of serving as biomarkers, MMN and P3a may be better indicators of illness progression and symptom severity in the early phases of psychosis.
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Article Synopsis
  • - QT prolongation is a serious heart rhythm issue linked to certain genes and can also be triggered by medications like antipsychotics and antidepressants.
  • - A review of 8 studies involving 3,838 psychiatric patients showed a genetic influence on medication-induced QT prolongation (MIQTP), identifying several key genes associated with this condition.
  • - The findings emphasize the need for careful monitoring of heart health in psychiatric care and suggest that genetic profiling could help enhance the safety of treatments.
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Article Synopsis
  • The study focuses on two brain waveforms, MMN and P3a, which are indicators of how we detect changes in sounds.
  • MMN reflects difficulties in auditory change detection, while P3a relates to the conscious evaluation of those sounds.
  • The researchers found no significant sex differences in these waveforms among healthy individuals, contributing valuable information to the existing research on how biological sex might influence auditory processing.
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Individuals with schizophrenia use on average twice as much caffeine than the healthy population, but the underlying cortical effects of caffeine in this population are still not well understood. Using resting electroencephalography (EEG) data, we can determine recurrent configurations of the electric field potential over the cortex. These configurations, referred to as microstates, are reported to be altered in schizophrenia and can give us insight into the functional dynamics of large-scale brain networks.

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