@article{pmid41857871,

title = {The Montreal model of ketamine-therapy for alcohol use disorder and comorbid treatment-resistant depression: protocol for a feasibility trial},

author = {Christina McAnulty and Philippe Lavoie and Samuel Cyr and Paola Lavin and Laurent Elkrief and Stephane Richard-Devantoy and Elie Rizkallah and Paul Lespérance and Nicolas Gamin and Anna Lembke and Didier Jutras-Aswad and Kyle Greenway and Nicolas Garel},

doi = {10.1136/bmjopen-2026-116969},

issn = {2044-6055},

year  = {2026},

date = {2026-03-01},

journal = {BMJ Open},

volume = {16},

number = {3},

pages = {e116969},

abstract = {BACKGROUND: Alcohol use disorder and treatment-resistant depression (TRD) often co-occur, presenting a major clinical challenge with limited effective treatments. However, ketamine produces rapid antidepressant effects and has shown promise in reducing alcohol use, and acceptance and commitment therapy (ACT) can be effective for both substance use and mood disorders. This study explores the feasibility and acceptability of combining ACT with ketamine within the framework of the Montreal Model-a structured, integrative psychedelic ketamine therapy developed for severe TRD.nnMETHODS AND ANALYSIS: This study is a single-group, open-label feasibility trial at the Centre hospitalier de l'Université de Montréal (CHUM) Neuromodulation Ketamine Clinic in Montreal, Canada. 30 participants diagnosed with both alcohol use disorder and treatment-resistant depression will receive eight weekly in-person or virtual ACT sessions in addition to six intravenous ketamine infusions. The primary outcome is feasibility, assessed through study completion and protocol adherence. Secondary outcomes include recruitment rate, tolerability, safety, data completeness and healthcare resource use. Exploratory measures will examine changes in depressive symptoms, alcohol use and quality of life using validated tools. A subset of participants will participate in semistructured qualitative interviews to explore their experiences.nnETHICS AND DISSEMINATION: This study was approved by the ethics committee of the CHUM on 14 May 2025. The results of the trial, including primary and secondary outcomes, will be published in peer-reviewed scientific journals.nnTRIAL REGISTRATION NUMBER: NCT06620276.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41701688,

title = {Exploring psychiatrists' perspectives on supporting parents with mental health Challenges: A mixed-methods study},

author = {Mireille Jasmin and Geneviève Piché and Aude Villatte and Andrea Reupert and Marie-Ève Clément and Anne Dorothee Müller and Marianne Fournier-Marceau and Darryl Maybery and Marie-Hélène Morin and Stéphane Richard-Devantoy},

doi = {10.1371/journal.pone.0342923},

issn = {1932-6203},

year  = {2026},

date = {2026-01-01},

journal = {PLoS One},

volume = {21},

number = {2},

pages = {e0342923},

abstract = {BACKGROUND: Parenting responsibilities can be particularly challenging for patients receiving mental health services, often resulting in a range of negative impacts on children. Incorporating a family-focused approach into the usual care of parents with mental illness has been recommended to promote patient recovery while supporting the well-being of children and the entire family unit. This study aimed to document the family-focused practices undertaken by psychiatrists working with parents who have a mental illness and to explore potential facilitators and barriers to these practices.nnMETHODS: A sequential explanatory mixed-method design was used, combining an online survey and individual interviews. Family-focused practices were reported by 27 psychiatrists through the French version of the Family-Focused Mental Health Practice Questionnaire. Follow-up qualitative individual interviews were conducted with 5 psychiatrists. Item-by-item analysis of the quantitative data was performed, followed by a thematic analysis of the qualitative data, integrating findings from both sources.nnRESULTS: Although psychiatrists acknowledge their patients' parenting role, most are reluctant to provide further support. Key barriers to family-focused practice include the predominantly individual-focused nature of psychiatric care, stigma, consent issues, and limited collaboration between adult and child services. Facilitators include psychiatrists' professional autonomy, personal experience, and confidence in conducting family meetings.nnCONCLUSION: Psychiatrists can play a pivotal role in identifying, acknowledging, and providing appropriate support to parents with mental illness and their families, including children. Developing comprehensive guidelines and targeted training is essential to equip psychiatrists with effective strategies for addressing parenting challenges in patients with complex mental health issues. Additionally, psychoeducational resources for children should be incorporated. Implementing these initiatives may lead to more compassionate, targeted care and improved outcomes for parents and their families.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40528492,

title = {The Music for Subanesthetic Infusions of Ketamine randomised clinical trial: ketamine as a psychedelic treatment for highly refractory depression},

author = {Kyle T Greenway and Nicolas Garel and Lê-Anh L Dinh-Williams and Julien Thibault Lévesque and Mendel Kaelen and Vincent Dagenais-Beaulé and Sara de la Salle and David Erritzoe and Karl Looper and Gustavo Turecki and Soham Rej and Séphane Richard-Devantoy},

doi = {10.1192/bjp.2025.102},

issn = {1472-1465},

year  = {2025},

date = {2025-06-01},

journal = {Br J Psychiatry},

pages = {1--9},

abstract = {BACKGROUND: Ketamine exerts potent but transient antidepressant effects in treatment-resistant depression (TRD). Combinations of ketamine and psychotherapy have attracted interest, but no trial has investigated a psychedelic model of ketamine-psychotherapy for TRD to our knowledge.nnAIMS: This secondary analysis of a randomised clinical trial (RCT) explores the therapeutic effects and experiential mechanisms of the Montreal Model of ketamine-psychotherapy for TRD, with or without music.nnMETHOD: A two-centre, single-blinded, RCT conducted in Montreal, Canada, between January 2021 and August 2022 (NCT04701866). Participants received ketamine-psychotherapy for TRD - six subanaesthetic infusions over 4 weeks and psychological support - with either music or matched non-music support during ketamine doses, as per random group assignments. The primary therapeutic outcome was the Montgomery-Åsberg Depression Rating Scale, assessed by blinded raters. Psychedelic-like experiences, evaluated by the Mystical Experience Questionnaire and Emotional Breakthrough Inventory, and their session-by-session relationships with depression were explored with multilevel, time-lagged covariate models with autoregressive residuals.nnRESULTS: Thirty-two participants with severe and highly comorbid TRD, including high rates of personality disorder and suicidality, received 181 ketamine infusions. Therapeutic outcomes and psychedelic experiences did not differ between music ( = 15) and non-music ( = 17) interventions. Both groups experienced significant reductions in clinician-rated and self-reported depression ( = 1.2 and  = 0.87, respectively;  < 0.001), anxiety ( = 0.8,  < 0.001) and suicidality ( = 0.4,  < 0.05) at 4 weeks, fully maintained at 8-week follow-up. Ketamine experiences were highly emotional and mystical. Converging analyses supported mystical-like ketamine experiences as mechanisms of its antidepressant effects.nnCONCLUSIONS: This trial found large and notably sustained benefits of ketamine-psychotherapy for severe TRD, with or without music, and psychedelic experiences of comparable intensity to those observed with psilocybin. Mystical-like experiences may particularly contribute to ketamine's immediate and persistent psychiatric benefits.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39644928,

title = {Cognitive control impairment in suicide behaviors: what do we know? A systematic review and meta-analysis of Stroop in suicide behaviors},

author = {Stéphane Richard-Devantoy and Ayla Inja and Marina Dicker and Josie-Anne Bertrand and Gustavo Turecki and M Orri and John G Keilp},

doi = {10.1016/j.jad.2024.12.009},

issn = {1573-2517},

year  = {2025},

date = {2025-03-01},

journal = {J Affect Disord},

volume = {372},

pages = {358--369},

abstract = {BACKGROUND: Suicidal behavior results from a complex interplay between stressful events and vulnerability factors, including cognitive deficits. Poorer performance on the Stroop task, a measure of cognitive control, has been associated with suicidal behavior in numerous studies. The objective was to conduct an updated systematic review of the literature on the Stroop task as a neuropsychological test of vulnerability to suicidal acts in patients with mood and other psychiatric disorders, while also looking at how the type (classic versus emotional) or the version (paper or computerized) of the Stroop task, as well as the characteristics of the patient (clinical population, age, sex) moderated the Stroop effect.nnMETHODS: A search on Medline, Embase, PsycInfo databases, and article references was performed. 53 studies (6781 participants) met the selection criteria. Interference time and errors of the Stroop Test were assessed in at least 3 studies to be analyzed. Moderators, such as the type (classic versus emotional) of the Stroop task and the characteristics of the patient (clinical population, age, sex) were also assessed.nnRESULTS: Interference time on Stroop performance was lower in suicide attempters than in patient controls (g = 0.20; 95%CI [0.10-0.30]) and healthy controls (g = 0.79; 95 % CI [0.29-1.29]), with patient controls scoring lower than healthy controls (g = -0.63; 95%CI [-1.01-0.25]). This was moderated by age and having a mood disorder. In terms of interference errors, suicide attempters performed worse than healthy controls (g = 0.57; 95%CI [0.01-1.15]) but did not perform differently from patient controls (g = 0.20; 95 % CI [-0.06-0.45]). Patient controls also did not score differently than healthy controls (g = -0.18; 95 % CI [-0.54-0.18]). There was a significant moderation effect for the type (i.e., original Stroop task) and version (i.e., paper format) of the Stroop task, and for some characteristics of the patient (i.e., older patients and having a mood disorder).nnCONCLUSIONS: Cognitive control impairment was associated with a history of suicidal behavior in patients, especially in older populations and those with mood disorders, however this result was moderated by outcome measure (interference time vs. errors), the type (i.e., original Stroop task) and the version (i.e., paper format) of the Stroop task. Cognitive control processes may be an important factor of suicidal vulnerability. Choosing the right neurocognitive test in the right population to detect suicide vulnerability is important direction for future research.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39580319,

title = {Emotional information processing in depressed elderly with suicidal behavior},

author = {Yoan Barsznica and Pierre Vandel and Bérénice Lambert and Julie Monnin and Magali Nicolier and Claire De Pinho and Julia Hickel and Stephane Richard-Devantoy and Cynthia Morgny and Monika Szymanska and Emmanuel Haffen and Eric Laurent and Gilles Chopard and Nicolas Noiret},

doi = {10.1016/j.encep.2024.09.004},

issn = {0013-7006},

year  = {2024},

date = {2024-11-01},

journal = {Encephale},

abstract = {Elderly suicide is a public health problem, especially in the presence of unipolar depression. Very few tools have been developed to assess suicide risk in the elderly. Suicidal behaviors (SB) are often associated with perturbations of emotional information processing. Recent eye-tracking evidence has indicated specific visual exploration of emotional facial expressions based on age, pathological status, or type of facial emotion expression, which encourage the development of more specific and reliable tools to help in the detection of SB in depressed elderly patients. The aim of this study was to characterize emotional facial information processing in elderly depressed patients with SB vs. patients without SB. We assessed fixation time on their facial expressions (SB n=10 and with noSB n=11). Results showed that depressed SB patients spent more time on emotional regions (i.e. eyes and mouth) of disgust, fear and neutral emotions than did depressed noSB patients. Conversely, fixation time did not differ between the groups for angry, sad and happy emotions. We discuss the difficulties in disengaging attention from emotional information congruent with the patient's emotional state. Specific visual exploration observed in suicidal depressed patients could be used as novel risk factors to more accurately assess and predict suicide risk.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38823590,

title = {The impact of antidepressant treatment on the network structure of neurocognition and core emotional depressive symptoms among depressed individuals with a history of suicide attempt: An 8-week clinical study},

author = {Stéphane Richard-Devantoy and Marcelo T Berlim and Nicolas Garel and Ayla Inja and Gustavo Turecki},

doi = {10.1016/j.jad.2024.05.111},

issn = {1573-2517},

year  = {2024},

date = {2024-09-01},

journal = {J Affect Disord},

volume = {361},

pages = {425--433},

abstract = {BACKGROUND: A more in-depth understanding of the relationship between depressive symptoms, neurocognition and suicidal behavior could provide insights into the prognosis and treatment of major depressive disorder (MDD) and suicide. We conducted a network analysis among depressed patients examining associations between history of suicide attempt (HSA), core emotional major depression disorder, and key neurocognitive domains.nnMETHOD: Depressed patients (n = 120) aged 18-65 years were recruited from a larger randomized clinical trial conducted at the Douglas Institute in Montreal, Canada. They were randomly assigned to receive one of two antidepressant treatments (i.e., escitalopram or desvenlafaxine) for 8 weeks. Core emotional MDD and key neurocognitive domains were assessed pre-post treatment.nnRESULTS: At baseline, an association between history of suicide attempt (HSA) and phonemic verbal fluency (PVF) suggested that HSA patients reported lower levels of the latter. After 8 weeks of antidepressant treatment, HSA became conditionally independent from PVF. Similar results were found for both the HAM-D and the QIDS-SR core emotional MDD/neurocognitive networks.nnCONCLUSION: Network analysis revealed a pre-treatment relationship between a HSA and decreased phonemic VF among depressed patients, which was no longer present after 8 weeks of antidepressant treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38315489,

title = {Music as an Intervention to Improve the Hemodynamic Response of Ketamine in Depression: A Randomized Clinical Trial},

author = {Kyle T Greenway and Nicolas Garel and Lê-Anh L Dinh-Williams and Serge Beaulieu and Gustavo Turecki and Soham Rej and Stephane Richard-Devantoy},

doi = {10.1001/jamanetworkopen.2023.54719},

issn = {2574-3805},

year  = {2024},

date = {2024-02-01},

journal = {JAMA Netw Open},

volume = {7},

number = {2},

pages = {e2354719},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38803674,

title = {Predictors of family-focused practices among mental health workers in Quebec},

author = {Geneviève Piché and Aude Villatte and Marie-Ève Clément and Marie-Hélène Morin and Darryl Maybery and Andrea Reupert and Stéphane Richard-Devantoy and Marianne Fournier-Marceau},

doi = {10.3389/fpsyt.2024.1380001},

issn = {1664-0640},

year  = {2024},

date = {2024-01-01},

journal = {Front Psychiatry},

volume = {15},

pages = {1380001},

abstract = {CONTEXT: Engaging family members in the ongoing care of individuals with mental illness is a practice known to bolster the client's recovery journey and enhance the overall wellbeing of both children and families involved. Despite its potential benefits, there remains a dearth of understanding surrounding the implementation of family-focused practices (FFP) by mental health professionals serving adults, as well as the factors that could either promote or hinder such practices. This knowledge gap is particularly pronounced within North American settings.nnGOAL: The goal of this study was to identify potential hindering and enabling factors of FFP used in adult mental health services.nnMETHODS: A sample of 512 professionals working with adult mental health clients, from all regions of Quebec, Canada, with a variety of disciplinary backgrounds and working in different work settings, completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Multinominal logistic regression analysis was performed to assess the impact of several factors - organizational, professional, and personal - on the degree of family-based practices of mental health workers.nnRESULTS AND DISCUSSION: Findings of this study show that the strongest predictors for the adoption of higher FFP levels among adult mental health professionals in Quebec, are being employed on a full-time basis, perceiving a higher level of skills, knowledge, and confidence toward FFP, and having a supportive workplace environment. Results underscore the need to address both organizational and worker-related aspects to effectively promote better FFP in mental health services.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37532888,

title = {Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report},

author = {Nicolas Garel and Kyle T Greenway and Lê-Anh L Dinh-Williams and Julien Thibault-Levesque and Didier Jutras-Aswad and Gustavo Turecki and Soham Rej and Stephane Richard-Devantoy},

doi = {10.1038/s41386-023-01689-y},

issn = {1740-634X},

year  = {2023},

date = {2023-08-01},

journal = {Neuropsychopharmacology},

abstract = {We present the first evidence that sub-anesthetic ketamine infusions for treatment resistant depression (TRD) may facilitate deprescription of long-term benzodiazepine/z-drugs (BZDRs). Long-term BZDR prescriptions are potentially harmful yet common, partly because of challenging withdrawal symptoms. Few pharmacological interventions have evidence for facilitating BZDR discontinuation, and none in patients actively suffering from TRD. In this ambi-directional cohort study, discontinuation of long-term (>6 month) BZDRs was attempted in 22 patients with severe unipolar or bipolar TRD receiving a course of six subanesthetic ketamine infusions over four weeks. We investigated the rates of successful BZDRs deprescription, trajectories of acute psychological withdrawal symptoms, and subsequent BZDRs abstinence during a mean follow-up of 1 year (primary outcome). Clinically significant deteriorations in depression, anxiety, sleep, and/or suicidality during the acute BZDR discontinuation phase were measured by repeated standardized scales and analyzed by latent growth curve models and percent correct classification analysis. Of the 22 eligible patients, all enrolled in this study and 91% (20/22) successfully discontinued all BZDRs by the end of the 4-week intervention, confirmed by urinary analyses. Less than 25% of discontinuers experienced any significant worsening of anxiety, depression, sleep difficulties, or suicidality during treatment. During follow-up (mean [range] duration, 12 [3-24] months), 64% (14/22) of patients remained abstinent from any BZDRs. These preliminary results suggest that ketamine infusions for TRD may facilitate the deprescription of BZDRs, even in patients with active depressive symptoms and significant comorbidity. Further investigation is warranted into this potential novel application of ketamine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38578187,

title = {[Family-focused practices among adult mental health professionals: A portrait of the situation in Quebec]},

author = {Geneviève Piché and Aude Villatte and Marie-Ève Clément and Marie-Hélène Morin and Marianne Fournier-Marceau and Darryl Maybery and Andrea Reupert and Stéphane Richard-Devantoy and Catherine Cyr-Villeneuve},

issn = {1708-3923},

year  = {2023},

date = {2023-01-01},

journal = {Sante Ment Que},

volume = {48},

number = {2},

pages = {121--150},

abstract = {Context Children living with a mentally ill parent are a vulnerable population, at higher risk of various psychosocial and mental health problems. They are overrepresented in youth mental health and child protection services. Adult mental health services that treat parents have the opportunity to identify and support children in these families. However, to date, there is still little knowledge on the extent of family-centered practices offered by professionals from different disciplinary fields in Quebec. Objective This study aims to document the family-focused practices of adult mental health professionals according to different disciplines (social work, nursing, psychoeducation, psychology, and special education). Method A total of 524 participants, from all regions of Quebec and working with adult mental health clients, responded to an online provincial survey. A subsample of 380 participants, members of a professional order or association, was retained for the present study. These come from five discipline: social work (n=127), nursing (n=99), psychoeducation (n=57), psychology (n=56) and special education (n=41) A MANCOVA analysis was performed to compare groups on the five subscales of the French version of the Family Focused Mental Health Practice (FFMHPQ-FR, Piché et al., in press), controlling for gender, years of experience working in mental health services and estimated proportion of clients with a parental role. Results Significant differences were found between social workers and psychologists in reported family-focused practices. Participants also reported very different levels of facilitating factors such as workplace support, openness to training, perceived knowledge and skills, and attitudes towards these practices. Discussion This study helps to increase knowledge on the use of family-focused practices by professionals from different disciplinary fields, in the context of adult mental health services in Quebec. The results allow to better support the adoption of such practices in mental health services.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37795512,

title = {The Montreal model: an integrative biomedical-psychedelic approach to ketamine for severe treatment-resistant depression},

author = {Nicolas Garel and Jessica Drury and Julien Thibault Lévesque and Nathalie Goyette and Alexandre Lehmann and Karl Looper and David Erritzoe and Shannon Dames and Gustavo Turecki and Soham Rej and Stephane Richard-Devantoy and Kyle T Greenway},

doi = {10.3389/fpsyt.2023.1268832},

issn = {1664-0640},

year  = {2023},

date = {2023-01-01},

journal = {Front Psychiatry},

volume = {14},

pages = {1268832},

abstract = {BACKGROUND: Subanesthetic ketamine has accumulated meta-analytic evidence for rapid antidepressant effects in treatment-resistant depression (TRD), resulting in both excitement and debate. Many unanswered questions surround ketamine's mechanisms of action and its integration into real-world psychiatric care, resulting in diverse utilizations that variously resemble electroconvulsive therapy, conventional antidepressants, or serotonergic psychedelics. There is thus an unmet need for clinical approaches to ketamine that are tailored to its unique therapeutic properties.nnMETHODS: This article presents the Montreal model, a comprehensive biopsychosocial approach to ketamine for severe TRD refined over 6 years in public healthcare settings. To contextualize its development, we review the evidence for ketamine as a biomedical and as a psychedelic treatment of depression, emphasizing each perspectives' strengths, weaknesses, and distinct methods of utilization. We then describe the key clinical experiences and research findings that shaped the model's various components, which are presented in detail.nnRESULTS: The Montreal model, as implemented in a recent randomized clinical trial, aims to synergistically pair ketamine infusions with conventional and psychedelic biopsychosocial care. Ketamine is broadly conceptualized as a brief intervention that can produce windows of opportunity for enhanced psychiatric care, as well as powerful occasions for psychological growth. The model combines structured psychiatric care and concomitant psychotherapy with six ketamine infusions, administered with psychedelic-inspired nonpharmacological adjuncts including rolling preparative and integrative psychological support.nnDISCUSSION: Our integrative model aims to bridge the biomedical-psychedelic divide to offer a feasible, flexible, and standardized approach to ketamine for TRD. Our learnings from developing and implementing this psychedelic-inspired model for severe, real-world patients in two academic hospitals may offer valuable insights for the ongoing roll-out of a range of psychedelic therapies. Further research is needed to assess the Montreal model's effectiveness and hypothesized psychological mechanisms.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37533588,

title = {Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings},

author = {Nicolas Garel and Julien Thibault Lévesque and Dasha A Sandra and Justin Lessard-Wajcer and Elizaveta Solomonova and Michael Lifshitz and Stéphane Richard-Devantoy and Kyle T Greenway},

doi = {10.3389/fnhum.2023.1200393},

issn = {1662-5161},

year  = {2023},

date = {2023-01-01},

journal = {Front Hum Neurosci},

volume = {17},

pages = {1200393},

abstract = {BACKGROUND: Psychedelic drug experiences are shaped by current-moment contextual factors, commonly categorized as internal (set) and external (setting). Potential influences of past environments, however, have received little attention.nnAIMS: To investigate how previous environmental stimuli shaped the experiences of patients receiving ketamine for treatment-resistant depression (TRD), and develop the concept of "imprinting" to account for such time-lagged effects across diverse hallucinogenic drugs.nnMETHODS: Recordings of treatment sessions and phenomenological interviews from 26 participants of a clinical trial investigating serial intravenous ketamine infusions for TRD, conducted from January 2021 to August 2022, were retrospectively reviewed. A broad literature search was undertaken to identify potentially underrecognized examples of imprinting with both serotonergic and atypical psychedelics, as well as analogous cognitive processes and neural mechanisms.nnRESULTS: In naturalistic single-subject experiments of a 28-year-old female and a 34-year-old male, subjective ketamine experiences were significantly altered by varying exposures to particular forms of digital media in the days preceding treatments. Higher levels of media exposure reduced the mystical/emotional qualities of subsequent psychedelic ketamine experiences, overpowering standard intention-setting practices and altering therapeutic outcomes. Qualitative data from 24 additional patients yielded eight further spontaneous reports of past environmental exposures manifesting as visual hallucinations during ketamine experiences. We identified similar examples of imprinting with diverse psychoactive drugs in past publications, including in the first-ever report of ketamine in human subjects, as well as analogous processes known to underly dreaming.nnCONCLUSIONS/INTERPRETATION: Past environmental exposures can significantly influence the phenomenology and therapeutic outcomes of psychedelic experiences, yet are underrecognized and understudied. To facilitate future research, we propose expanding the contextual model of psychedelic drug actions to incorporate imprinting, a novel concept that may aid clinicians, patients, and researchers to better understand psychedelic drug effects.nnCLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT04701866.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36087563,

title = {Efficacy of ketamine intervention to decrease alcohol use, cravings, and withdrawal symptoms in adults with problematic alcohol use or alcohol use disorder: A systematic review and comprehensive analysis of mechanism of actions},

author = {Nicolas Garel and Christina McAnulty and Kyle T Greenway and Paul Lesperance and Jean-Philippe Miron and Soham Rej and Stephane Richard-Devantoy and Didier Jutras-Aswad},

doi = {10.1016/j.drugalcdep.2022.109606},

issn = {1879-0046},

year  = {2022},

date = {2022-10-01},

journal = {Drug Alcohol Depend},

volume = {239},

pages = {109606},

abstract = {BACKGROUND: Alcohol use disorder is highly prevalent and has important economical, societal, psychiatric, and medical consequences. All currently approved therapeutic approaches targeting alcohol dependence have relatively modest effects and high relapse rates. Recent evidence suggests that ketamine may be an effective intervention to treat alcohol use disorder and alcoholic withdrawal. This systematic review aimed to assess the current level of evidence for this intervention.nnMETHODS: This systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered on the international database of systematic reviews PROSPERO. Medline(Ovid), CINAHL Complete(EBSCOhost), PsycINFO(Ovid), EBM Reviews(Ovid), EMBASE(Ovid), and Google Scholar were searched for studies using ketamine to treat harmful alcohol use, craving, or withdrawal states in humans. Studies of any methodology that evaluated ketamine in isolation or combination with other interventions were included. The risk of bias was assessed using specific Cochrane critical appraisal tools.nnRESULTS: Of 1922 abstracts identified, 8 full-text articles were eligible for inclusion, yielding a total sample size of 634 participants. Five studies investigated the impact of ketamine on alcohol use and/or cravings and/or withdrawal in outpatient settings. Three studies looked at the effect of adding ketamine to conventional treatment of withdrawal symptoms in participants admitted to intensive care unit for severe alcohol withdrawal. Results on primary outcomes were mixed within and across trials.nnCONCLUSIONS: Despite promising results, the current evidence does not permit definitive conclusions about the efficacy of ketamine in alcohol use disorders or withdrawal. Future studies are warranted.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35143124,

title = {Clinical Dimensions Associated With Psychological Pain in Suicidal Patients: One-Year Follow-up Study},

author = {Adrián Alacreu-Crespo and Sebastien Guillaume and Stephane Richard-Devantoy and Aurelie Cazals and Emilie Olié and Philippe Courtet},

doi = {10.4088/JCP.21m14065},

issn = {1555-2101},

year  = {2022},

date = {2022-02-01},

journal = {J Clin Psychiatry},

volume = {83},

number = {2},

abstract = { Psychological pain is a transdiagnostic factor in mental health and a key clinical dimension to understand suicide in patients with mood disorders. However, less is known about the clinical characteristics that predict high psychological pain. The aim of this study was to fill this gap in a sample of patients with mood disorders.  Inpatients admitted for a major depressive episode, according to  criteria, from 2010 to 2017 were divided into 3 groups: 178 recent suicide attempters (within the last 7 days), 101 past suicide attempters (lifetime history of suicide attempt), and 93 nonattempters (no lifetime history of suicidal act). At inclusion, current psychopathology, medication, personality traits (impulsivity, anxiety, hopelessness), and childhood trauma were assessed. At inclusion and at 1-year follow-up, depressive symptomatology and current and maximal (within the 15 last days) psychological and physical pain were assessed.  At baseline, maximal psychological pain was higher in recent than in past suicide attempters (odds ratio [OR] = 1.18 [1.04-1.35]) and nonattempters (OR = 1.32 [1.16-1.50]). In the multivariate model, depression severity (OR = 1.11 [1.08-1.16]) and worst physical pain (OR = 2.53 [1.28-5.02]) predicted high psychological pain, whereas bipolar disorder (OR = 0.54 [0.29-0.98]) predicted low psychological pain. During the follow-up, the change in maximal psychological pain was predicted by changes in depressive symptomatology (β = 0.46,  < .001) and maximal physical pain (β = 0.42,  < .003). Finally, among depressive symptoms, guilt, lack of initiative, and loss of appetite better explained maximal psychological pain, both at inclusion and at 1 year (all  < .050).  Psychological pain is associated with a recent suicidal act and depressive severity. Due to the strong link between psychological pain and physical pain, future studies should investigate whether psychotropic drugs with analgesic effects protect from psychological pain and therefore from suicide.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36118690,

title = {Mindfulness-based cognitive therapy vs. a health enhancement program for the treatment of late-life depression: Study protocol for a multi-site randomized controlled trial},

author = {Magnus Bein and Myriam Lesage and Elena Dikaios and Mallar Chakravarty and Zindel Segal and Isabelle Royal and Mark Speechley and Alessandra Schiavetto and Daniel Blumberger and Matthew D Sacchet and Joseph Therriault and Johanna Gruber and Valerie Tourjman and Stephane Richard-Devantoy and Vasavan Nair and Marie-Andrée Bruneau and Soham Rej and Michael Lifshitz and Harmehr Sekhon},

doi = {10.3389/fnagi.2022.976636},

issn = {1663-4365},

year  = {2022},

date = {2022-01-01},

journal = {Front Aging Neurosci},

volume = {14},

pages = {976636},

abstract = {BACKGROUND: Late-life depression (LLD) affects up to 18% of older adults and has been linked to elevated dementia risk. Mindfulness-based cognitive therapy (MBCT) holds promise for treating symptoms of depression and ameliorating cognitive deficits in older adults. While preliminary findings are promising, a definitive RCT investigating its effects on late life depression and cognition have not yet been conducted. We present a protocol describing a multi-site blinded randomized controlled trial, comparing the effects of MBCT and of an active control, a Health Enhancement Program (HEP), on depressive symptoms, executive functioning, and brain biomarkers of LLD, among several other exploratory outcomes.nnMETHODS: Two-hundred and thirteen ( = 213) patients with LLD will be recruited at various centers in Montreal, QC, Canada. Participants will undergo stratified randomization to either MBCT or HEP intervention groups. We will assess changes in (1) depression severity using the Hamilton Depression Rating Scale (HAM-D17), (2) processing speed and executive functioning, (3) brain biomarkers of LLD (hippocampal volume, default network resting-state functional connectivity and executive network resting-state functional connectivity), and (4) other exploratory physiological and mood-based measures, at baseline (0 weeks), post intervention (8 weeks), and 26 weeks after baseline.nnDISCUSSION: The proposed study will assess the clinical potential of MBCT to improve symptoms of depression, as well as examine its impact on cognitive impairments and neurobiological markers, and thus inform its use as a promising adjunct in the treatment of LLD.nnCLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier: NCT05366088.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32312344,

title = {The network structure of core depressive symptom-domains in major depressive disorder following antidepressant treatment: a randomized clinical trial},

author = {Marcelo T Berlim and Stephane Richard-Devantoy and Nicole Rodrigues Dos Santos and Gustavo Turecki},

doi = {10.1017/S0033291720001002},

issn = {1469-8978},

year  = {2021},

date = {2021-10-01},

journal = {Psychol Med},

volume = {51},

number = {14},

pages = {2399--2413},

abstract = {BACKGROUND: Network analysis (NA) conceptualizes psychiatric disorders as complex dynamic systems of mutually interacting symptoms. Major depressive disorder (MDD) is a heterogeneous clinical condition, and very few studies to date have assessed putative changes in its psychopathological network structure in response to antidepressant (AD) treatment.nnMETHODS: In this randomized trial with adult depressed outpatients (n = 151), we estimated Gaussian graphical models among nine core MDD symptom-domains before and after 8 weeks of treatment with either escitalopram or desvenlafaxine. Networks were examined with the measures of cross-sectional and longitudinal structure and connectivity, centrality and predictability as well as stability and accuracy.nnRESULTS: At baseline, the most connected MDD symptom-domains were fatigue-cognitive disturbance, whereas at week 8 they were depressed mood-suicidality. Overall, the most central MDD symptom-domains at baseline and week 8 were, respectively, fatigue and depressed mood; in contrast, the most peripheral symptom-domain across both timepoints was appetite/weight disturbance. Furthermore, the psychopathological network at week 8 was significantly more interconnected than at baseline, and they were also structurally dissimilar.nnCONCLUSION: Our findings highlight the utility of focusing on the dynamic interaction between depressive symptoms to better understand how the treatment with ADs unfolds over time. In addition, depressed mood, fatigue, and cognitive/psychomotor disturbance seem to be central MDD symptoms that may be viable targets for novel, focused therapeutic interventions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33962353,

title = {Low MoCA performances correlate with suicidal ideation in late-life depression},

author = {Stéphane Richard-Devantoy and Icoquih Badillo-Amberg and Kyle T Greenway and Maria Di Tomasso and Gustavo Turecki and J A Bertrand},

doi = {10.1016/j.psychres.2021.113957},

issn = {1872-7123},

year  = {2021},

date = {2021-07-01},

journal = {Psychiatry Res},

volume = {301},

pages = {113957},

abstract = {Late-life depression remains an underdiagnosed clinical entity, mainly because the presence of cognitive impairment in the elderly leads clinicians to suspect dementia rather than depression. Our objective was to analyze the cognitive abilities of elderly depressed patients using the Montreal Cognitive Assessment (MoCA) in relation to the presence or absence of suicidal ideation. The MoCA, Beck Scale of Suicidal Ideation, Hamilton Anxiety Scale, and Hamilton Depression Scale were administered to 72 patients with a recent history of late life depression: 43 with suicidal ideation and 29 non-suicidal controls. The results show that suicidal patients demonstrated significantly worse performance on the MoCA total score and the delayed recall subtest in comparison to non-suicidal controls. In addition, after adjusting for age and depression, poorer performance on the MoCA total score correlated to the presence of suicidal ideation. We found that the MoCA total score is able to predict the presence of suicidal ideation in depressed elderly patients in a fair-to-good manner. As late-life depression is already established as a potential prodrome of dementia, longitudinal follow-up may determine whether depressed individuals with suicidal ideation are at higher risk of converting to dementia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33902087,

title = {Adjunctive music improves the tolerability of intravenous ketamine for bipolar depression},

author = {Kyle T Greenway and Nicolas Garel and Nathalie Goyette and Gustavo Turecki and Stephane Richard-Devantoy},

doi = {10.1097/YIC.0000000000000363},

issn = {1473-5857},

year  = {2021},

date = {2021-07-01},

journal = {Int Clin Psychopharmacol},

volume = {36},

number = {4},

pages = {218--220},

abstract = {Intravenous ketamine is an effective treatment of bipolar depression. One of its most important side-effects is a transient altered state of consciousness commonly referred to as dissociation. These states can be anxiety-provoking, distressing and even treatment-limiting, warranting research into mitigation strategies. In this article, we present two cases that demonstrate the potential of adjunctive music to diminish the distress associated with ketamine-induced dissociation - though not necessarily its degree - in bipolar 1 disorder. Both patients suffering from severe depression underwent their first ketamine infusion without music and opted for music with subsequent infusions. They reported that music significantly improved the tolerance of their dissociative symptoms, thereby reducing distress and facilitating subsequent treatments. Both patients achieved remission from their highly treatment-resistant depressive episodes following six ketamine infusions. This is the first report of music's benefits on ketamine for bipolar 1 depression, though there is precedence in the scientific literature on 'psychedelics' where the use of music in combination with medication-induced altered states has been studied. The principles regarding music selection that have resulted from this paradigm may be applicable to the use of ketamine in unipolar and bipolar depression. The optimal use of music with ketamine warrants further research.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33275047,

title = {Psychological pain and depression: it's hard to speak when it hurts},

author = {Stéphane Richard-Devantoy and Josie-Anne Bertrand and Séverine Béziat and Isabelle Jaussent and Aurélie Cazals and Déborah Ducasse and Kyle T Greenway and Sébastien Guillaume and Philippe Courtet and Emilie Olié},

doi = {10.1080/13651501.2020.1836225},

issn = {1471-1788},

year  = {2021},

date = {2021-06-01},

journal = {Int J Psychiatry Clin Pract},

volume = {25},

number = {2},

pages = {180--186},

abstract = {OBJECTIVE: To investigate the neuropsychological features of depressed patients reporting high level of psychological pain.nnMETHODS: Sixty-two inpatients were included and divided into two groups according to the level of psychological pain assessed by a Likert scale. Cognitive abilities were assessed using the Trail Making Test, the Stroop test, and Verbal Fluency Test (semantic and phonemic verbal fluency). Univariate and multivariate analyses were performed to determine neuropsychological factors associated with a high level of psychological pain.nnRESULTS: The median level of psychological pain was 8/10. High level of psychological pain was associated with poor phonemic verbal fluency performance in men ( = 0.009), but not in women, even after controlling for confounding factors (age, level of depression, anxiety). Groups did not differ on the Trail Making Test, the Stroop test, or the semantic verbal fluency measure.nnCONCLUSION: Psychological pain is a specific clinical entity that should be considered to be more significant than just a symptom of depression. High level of psychological pain appears to be associated with a deficit of phonemic verbal fluency in depressed men. This finding could help to target psychotherapeutic treatments and improve screening.Key pointsPatients with high psychological pain do not differ on the Trail Making Test, the Stroop Test or the Sematic Verbal Fluency Measure to patients with low psychological painHigh psychological pain is associated with a deficit in phonemic verbal fluency in depressed menFuture research should aim to clarify gender differences in psychological pain in participants with and without major depressive disorder, as well as explore the complex relationship between cognition and the different forms of pain (psychological, physical and psychosomatic).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid31818122,

title = {A systematic review of older adults' request for or attitude toward euthanasia or assisted-suicide},

author = {Dolores Angela Castelli Dransart and Sylvie Lapierre and Annette Erlangsen and Silvia Sara Canetto and Marnin Heisel and Brian Draper and Reinhard Lindner and Stephane Richard-Devantoy and Gary Cheung and Paolo Scocco and Ricardo Gusmão and Diego De Leo and Ken Inoue and Vincent De Techterman and Amy Fiske and Jin Pyo Hong and Marjolaine Landry and Andrée-Anne Lepage and Isabelle Marcoux and Peter Jongho Na and Eva Neufeld and Deborah Ummel and Jan-Henrik Winslov and Christine Wong and Jing Wu and Marilyn Wyart},

doi = {10.1080/13607863.2019.1697201},

issn = {1364-6915},

year  = {2021},

date = {2021-03-01},

journal = {Aging Ment Health},

volume = {25},

number = {3},

pages = {420--430},

abstract = {OBJECTIVES: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, religious, or existential) associated with attitudes toward, wishes and requests for, as well as death by EUT/PAS among individuals aged 60 years and over.nnMETHOD: The search for quantitative studies in PsycINFO and MEDLINE databases was conducted three times from February 2016 until April 2018. Articles of probable relevance ( = 327) were assessed for eligibility. Studies that only presented descriptive data ( = 306) were excluded.nnRESULTS: This review identified 21 studies with predictive analyses, but in only 4 did older adults face actual end-of-life decisions. Most studies (17) investigated attitudes toward EUT/PAS (9 through hypothetical scenarios). Younger age, lower religiosity, higher education, and higher socio-economic status were the most consistent predictors of endorsement of EUT/PAS. Findings were heterogeneous with regard to physical health, psychological, and social factors. Findings were difficult to compare across studies because of the variety of sample characteristics and outcomes measures.nnCONCLUSION: Future studies should adopt common and explicit definitions of EUT/PAS, as well as research designs (e.g. mixed longitudinal) that allow for better consideration of personal, social, and cultural factors, and their interplay, on EUT/PAS decisions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}