Experiential Training in Psychedelic-Assisted Therapy: A Risk-Benefit Analysis.

Well-trained, competent therapists are crucial for safe and effective psychedelic-assisted therapy (PAT). The question whether PAT training programs should require aspiring therapists to undergo their own PAT-commonly referred to as "experiential training"-has received much attention within the field. In this article, we analyze the potential benefits of experiential training in PAT by applying the framework developed by Rolf Sandell et al.

"Don't Just Study our Distress, Do Something": Implementing and Evaluating a Modified Stepped-Care Model for Health Care Worker Mental Health During the COVID-19 Pandemic.

Objective: Throughout the COVID-19 pandemic, there have been concerns about the mental health of health care workers (HCW). Although numerous studies have investigated the level of distress among HCW, few studies have explored programs to improve their mental well-being. In this paper, we describe the implementation and evaluation of a program to support the mental health of HCW at University Health Network (UHN), Canada's largest healthcare network.

Initial findings on RESTORE for healthcare workers: an internet-delivered intervention for COVID-19-related mental health symptoms.

Many healthcare workers on the frontlines of the COVID-19 pandemic are experiencing clinical levels of mental health symptoms. Evidence-based interventions to address these symptoms are urgently needed. RESTORE (Recovering from Extreme Stressors Through Online Resources and E-health) is an online guided transdiagnostic intervention including cognitive-behavioral interventions.

Development of RESTORE: an online intervention to improve mental health symptoms associated with COVID-19-related traumatic and extreme stressors.

Background: Frontline healthcare workers, recovered COVID+ patients who had severe illness, and close others of COVID+ patients who have recovered or died are at risk for clinical levels of mental health symptoms in the context of the COVID-19 pandemic. RESTORE (ecovering from xtreme tressors hrough nline esources and -health) was specifically designed for this context. RESTORE is a transdiagnostic guided online intervention adapted from evidence-based cognitive-behavioural therapies.

Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic: A Qualitative Analysis.

Importance: Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic.

Objective: To examine sources of distress and concern for HCWs in Canada during the COVID-19 pandemic.

Design, Setting, And Participants: In this qualitative study, a critical discourse analysis was performed of questions posed by HCWs to hospital senior leadership between March 16, 2020, and December 1, 2020, through an online employee forum as part of a larger mixed-methods evaluation of a stepped-care mental health support program for HCWs at 1 of Canada's largest health care institutions.

Donor outcomes in anonymous live liver donation.

Background & Aims: Death rates on liver transplant waiting lists range from 5%-25%. Herein, we report a unique experience with 50 anonymous individuals who volunteered to address this gap by offering to donate part of their liver to a recipient with whom they had no biological connection or prior relationship, so called anonymous live liver donation (A-LLD).

Methods: Candidates were screened to confirm excellent physical, mental, social, and financial health.

The 2018 ISHLT/APM/AST/ICCAC/STSW Recommendations for the Psychosocial Evaluation of Adult Cardiothoracic Transplant Candidates and Candidates for Long-term Mechanical Circulatory Support.

The psychosocial evaluation is well-recognized as an important component of the multifaceted assessment process to determine candidacy for heart transplantation, lung transplantation, and long-term mechanical circulatory support (MCS). However, there is no consensus-based set of recommendations for either the full range of psychosocial domains to be assessed during the evaluation, or the set of processes and procedures to be used to conduct the evaluation, report its findings, and monitor patients' receipt of and response to interventions for any problems identified. This document provides recommendations on both evaluation content and process.

The 2018 ISHLT/APM/AST/ICCAC/STSW recommendations for the psychosocial evaluation of adult cardiothoracic transplant candidates and candidates for long-term mechanical circulatory support.

The psychosocial evaluation is well-recognized as an important component of the multifaceted assessment process to determine candidacy for heart transplantation, lung transplantation, and long-term mechanical circulatory support (MCS). However, there is no consensus-based set of recommendations for either the full range of psychosocial domains to be assessed during the evaluation, or the set of processes and procedures to be used to conduct the evaluation, report its findings, and monitor patients' receipt of and response to interventions for any problems identified. This document provides recommendations on both evaluation content and process.

One-Year Outcomes in Caregivers of Critically Ill Patients.

Background: Few resources are available to support caregivers of patients who have survived critical illness; consequently, the caregivers' own health may suffer. We studied caregiver and patient characteristics to determine which characteristics were associated with caregivers' health outcomes during the first year after patient discharge from an intensive care unit (ICU).

Methods: We prospectively enrolled 280 caregivers of patients who had received 7 or more days of mechanical ventilation in an ICU.

Time to Consultation-Liaison Psychiatry Service Referral as a Predictor of Length of Stay.

Objectives: The aim of this study was to determine the relationship between the time to referral (TTR) to psychiatric consultation and the length of stay (LOS) after adjusting for medical comorbity.

Methods: Using a naturalistic study design, we collected and analyzed inpatient consultation-liaison psychiatry service data over a 12-month period from 2 Canadian hospital sites. Data collected included demographic characteristics, referral characteristics, Charlson Comorbidity Index to measure medical comorbidity severity, psychiatric diagnoses, type of psychiatric intervention, and time variables, namely TTR and LOS.

The RECOVER Program: Disability Risk Groups and 1-Year Outcome after 7 or More Days of Mechanical Ventilation.

Rationale: Disability risk groups and 1-year outcome after greater than or equal to 7 days of mechanical ventilation (MV) in medical/surgical intensive care unit (ICU) patients are unknown and may inform education, prognostication, rehabilitation, and study design.

Objectives: To stratify patients for post-ICU disability and recovery to 1 year after critical illness.

Methods: We evaluated a multicenter cohort of 391 medical/surgical ICU patients who received greater than or equal to 1 week of MV at 7 days and 3, 6, and 12 months after ICU discharge.

Heart transplants: Identity disruption, bodily integrity and interconnectedness.

Of heart transplant recipients, 30 per cent report ongoing or episodic emotional issues post-transplant, which are not attributable to medications or pathophysiological changes. To this end, our team theorized that cardiac transplantation introduces pressing new questions about how patients incorporate a transplanted heart into their sense of self and how this impacts their identity. The work of Merleau-Ponty provided the theoretical underpinning for this project as it rationalizes how corporeal changes affect one's self and offer an innovative framework to access these complex aspects of living with a transplanted heart.

(Dis)orientation of international medical graduates: an approach to foster teaching, learning, and collaboration (TLC).

Objective: The Teaching for Learning and Collaboration (TLC) Program is a teaching-skills program focusing on methods to improve student learning. This program was adopted to address the professional and personal challenges faced by International Medical Graduates (IMGs) completing a fellowship in psychosomatic medicine.

Method: The authors conducted a literature review on the educational challenges encountered by IMGs.

The influence of somatic symptoms on Beck Depression Inventory scores in hospitalized postmyocardial infarction patients.

Objective: The Beck Depression Inventory (BDI) has been used more than any other self-report questionnaire in research on depression in cardiovascular disease. However, no studies have examined whether BDI scores may be influenced by somatic symptoms common after myocardial infarction (MI) that may overlap with symptoms of depression. The objective of this study was to examine whether BDI scores of post-MI patients may be influenced by somatic symptoms that commonly occur after MI, but may not be related to depression.

Preparation and Support of Patients through the Transplant Process: Understanding the Recipients' Perspectives.

Preparation for heart transplant commonly includes booklets, instructional videos, personalized teaching sessions, and mentorship. This paper explores heart transplant recipients' thoughts on their preparation and support through the transplant process. Twenty-five interviews were audio-/videotaped capturing voice and body language and transcribed verbatim.

The role of attachment style and depression in patients with hepatitis C.

Patients infected with chronic hepatitis C virus (HCV) commonly suffer from the triad of depression, pain and fatigue. This symptom triad in HCV is likely influenced by additional psychological and interpersonal factors, although the relationship is not clearly understood. This retrospective study aimed to characterize the relationship between attachment style and depressive and physical symptoms in the HCV-infected population.

Symptom reporting on the Beck Depression Inventory among post-myocardial infarction patients: in-hospital versus follow-up assessments.

Objective: Depressive symptoms following myocardial infarction (MI) are often assessed using self-report questionnaires, such as the Beck Depression Inventory (BDI). No studies have examined whether depressive symptom scores assessed by self-report questionnaires during hospitalization post-MI are influenced by factors related to the acute event or hospitalization compared to subsequent outpatient assessments of the same patients. The objective of this study was to compare BDI total scores, somatic scores, and cognitive/affective scores among post-MI patients in-hospital versus at post-discharge follow-up.

Identifying opportunities to improve management of autoimmune hepatitis: evaluation of drug adherence and psychosocial factors.

Background & Aims: Recognizing the importance of adherence to therapy in autoimmune hepatitis (AIH) is critical for patient care and avoidance of unnecessary intervention. The influence of psychosocial factors on treatment adherence needs better understanding and prominence. We sought to determine the association between anxiety, depressive symptoms, and avoidant relationship style on self-reported immunosuppressant medication adherence and treatment response in patients with AIH.

Preparing international medical graduates for psychiatry residency: a multi-site needs assessment.

Objective: Despite the growing number of international medical graduates (IMGs) training in medicine in Canada and the United States, IMG-specific challenges early in psychiatry residency have not been fully explored. Therefore, the authors conducted a needs-assessment survey to determine the needs of IMGs transitioning into psychiatry residency.

Method: Using a 15-item online questionnaire, authors conducted a needs-assessment of IMG residents in five Canadian psychiatry residency programs.

A genetic predisposition to produce low levels of IL-10 is related to depressive symptoms: a pilot study of patients with end stage renal disease.

Objective: Heightened levels of inflammation may be associated with an increased risk of depression, particularly among those with inflammatory medical conditions. Although elevated rates of both systemic inflammation and depression have been documented among patients with end stage renal disease (ESRD), the link between these factors has received little empirical evaluation. The goal of this pilot study was to investigate the association between cytokine gene polymorphisms (that are known to influence pro- and anti-inflammatory cytokine production) and depressive symptoms among patients with ESRD.

A comparison of depression screening instruments in hepatitis C and the impact of depression on somatic symptoms.

Objective: Treatment of hepatitis C (HCV) with pegylated interferon-alpha (IFNα) can cause depression in approximately 30% of patients and underscores the need for effective detection of depression prior to and during IFNα treatment. Elevated rates of depression in untreated HCV can be a barrier to initiating HCV therapy and can impact fatigue and physical symptoms. In this preliminary study, we examined the accuracy of the seven-item Hamilton Depression Rating Scale (HAM-7) and Patient Health Questionnairre-9 (PHQ-9) in detecting depression in HCV-infected patients and determined the effect of major depression on somatic symptoms.

Qualitative interviews vs standardized self-report questionnaires in assessing quality of life in heart transplant recipients.

Quality of life (QoL) studies in heart transplant recipients (HTRs) using validated, quantitative, self-report questionnaires have reported poor QoL in approximately 20% of patients. This consecutive mixed methods study compared self-report questionnaires, the Medical Outcomes Study 36-item Short Form Health Survey (MOS SF-36) and the Atkinson Life Satisfaction Scale, with phenomenologically informed audiovisual (AV) qualitative interview data in 27 medically stable HTRs (70% male; age 53 ± 13.77 years; time since transplant 4.

Both patient and caregiver gender impact depressive symptoms among organ transplant caregivers: who is at risk and why?

This study investigated the impact of patient and caregiver gender on caregiver depressive symptoms. Caregivers' use of relationship-focused coping and dimensions of caregiver burden were examined as potential mediators of gender differences in depressive symptoms. Ninety-three organ transplant candidates and their caregivers completed written questionnaires (N = 186).

Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality.

Background: Symptom dimensions of post myocardial infarction (MI) depression may be differently related to prognosis. Somatic/affective symptoms appear to be associated with a worse cardiac outcome than cognitive/affective symptoms. We examined the relationship between depressive symptom dimensions following acute coronary syndrome (ACS) and both disease severity and all-cause mortality.