CAMH

Apartment and condo dwellers report smelling cannabis more than tobacco smoke, �鶹��Ƶ researchers say

geoff.vendeville — Fri, 13 Sep 2019 14:50:49 +0000

Apartment and condo dwellers report smelling cannabis more than tobacco smoke, �鶹��Ƶ researchers say

geoff.vendeville Fri, 09/13/2019 - 10:50

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The �鶹��Ƶ study on exposure to cannabis smoke may help inform the debate on how to regulate cannabis, one of the author says (photo by Cavan Images/Getty Images)

Heidi Singer

Topic

Breaking Research

Cannabis

CAMH

Dalla Lana School of Public Health

Health

Research & Innovation

More people in apartment buildings and condominiums reported exposure to cannabis smoke than tobacco one year before legalization, a new University of Toronto study says.

The �鶹��Ƶ public-health researchers based their findings on a telephone survey of Ontario adults by the Centre for Addiction and Mental Health in 2017. Extrapolating from the CAMH results, the researchers suggest about 827,000 people in multi-unit dwellings were exposed to cannabis smoke from hallways, other units or elsewhere in their building – as opposed to about 728,000 who smelled tobacco smoke.

“I was surprised there were more reports of cannabis than tobacco,” says co-author Michael Chaiton (pictured left), an associate professor in the Dalla Lana School of Public Health. “We’ve known anecdotally there had been increasing calls and complaints about cannabis smoke, but we hadn’t been able to quantify it until now.”

Chaiton hopes the results will contribute to the debate over whether to regulate cannabis like alcohol, by forbidding its consumption in public spaces, or like tobacco, by prohibiting its use in indoor public spaces or near buildings.

He and his co-authors Alanna Chu and Pamela Kaufman, an assistant professor at Dalla Lana, published their study on Sept. 10 in the International Journal of Environmental Research and Public Health.

The team has been tracking exposure to tobacco smoke in residential buildings for many years, and recently they have become increasingly concerned about cannabis second-hand smoke.

Despite the surprising results, Chaiton says it’s very possible that the study underreported cannabis exposure, since the authors found people who consume cannabis themselves were more likely to report smelling it – suggesting that not everybody can identify cannabis by its pungent scent.

The study, the first to examine the prevalence of involuntary cannabis exposure in residential buildings, also showed that people of lower income, who more often live in multi-unit buildings, are at higher risk of exposure to second-hand smoke and any related health effects from other people’s cannabis use.

But those health effects are not yet fully clear.

Third-hand smoke, the residue from smoke that clings to walls and furniture or settles in dust, is a particular concern for tobacco because nicotine is sticky and accumulates easily on surfaces like drapery, clothing and furniture.

But Chaiton says researchers don’t yet know whether cannabis travels the same way through apartment buildings, including ventilation systems, or how it contributes to third-hand smoke contamination.

The next step is to determine whether exposure reports have increased since the legalization of cannabis in October 2018.

“If there are more people smoking cannabis or smoking more freely, indoor use in buildings may increase,” Chaiton says. “But, on the other hand, people may be more willing to go outside, lessening second-hand exposure indoors. As well, people may be less likely to report it to surveyors because it’s legal – or they may be more likely to complain if they have less fear of repercussions.”

Funding for the study was provided by the Canadian Institutes for Health Research and the Ontario Ministry of Health and Long-Term Care.

�鶹��Ƶ psychiatrists launch initiative to spot signs of psychosis early in adolescence

ullahnor — Thu, 09 Feb 2017 21:43:04 +0000

�鶹��Ƶ psychiatrists launch initiative to spot signs of psychosis early in adolescence

ullahnor Thu, 02/09/2017 - 16:43

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Painting by Toronto artist Jessgo at the inaugural Miner's Lamp award dinner in 2016, an initiative of IAMGOLD and partners to support �鶹��Ƶ psychiatry research (photo courtesy of Faculty of Medicine)

Carolyn Morris

Author legacy

Carolyn Morris

Topic

Adolescence is a challenging period for everyone, but for those with mental illness, it’s particularly sensitive.

Between the ages of 14 and 25 – known as a “transition age” – is a time when symptoms of psychosis are known to appear. It's also when people switch from child mental health services into adult care – not always a seamless process.

Joanna Henderson, an assistant professor, and Dr. Aristotle Voineskos, an associate professor, both from �鶹��Ƶ Faculty of Medicine's department of psychiatry and CAMH, are launching a new research project aimed at identifying early signs of psychosis. The ideas is that if we could spot the signs early, we could potentially ensure continuous care for the most vulnerable.

They spoke with �鶹��Ƶ's Carolyn Morris about the new initiative, which is receiving key funding from the Miner’s Lamp Innovation Fund in the Prevention and Early Detection of Severe Mental Illness, a philanthropic initiative of IAMGOLD Corp. and its partners.

How are you setting out to identify the signs of psychosis early?

Aristotle Voineskos: Due largely to the way the brain develops, symptoms of psychosis only tend to emerge in mid to late adolescence. And while we’ve found certain associated biological or social factors, for the most part, researchers haven’t yet figured out what puts certain people at higher risk of developing psychosis symptoms later on.

These are much more common in youth than people realize – up to 20 per cent in the community if you include mild symptoms. We’re not talking about risk for schizophrenia. That’s not what this study is about. Instead, we’re focused on studying the number, severity and course of psychosis symptoms over time, and how those symptoms impact functioning.

One place we often forget to look at is young people who already have a mental health condition. Early psychosis has typically been the domain of adult psychiatrists, but we really need to partner with child and youth psychiatrists to understand trajectories of development and illness.

Recent research findings have found that kids who are diagnosed with conditions like autism spectrum disorder, oppositional defiant disorder or ADHD are at a higher risk of developing symptoms of psychosis later on. But that’s still a broad group of people, and only a fraction of them will actually go on to struggle with psychosis so we’re planning to follow a group over time and try to identify other possible signs that might serve as red flags.

What happens in our current system?

Joanna Henderson: There can be a number of challenges getting access to care, but if all goes well, a young person who is experiencing difficulties would be getting the care they need for ADHD or other diagnoses.

They might get referred to a psychiatrist, receive a diagnosis and be provided with medication or other treatment. Once they are adjusting and doing well, they would stop seeing the psychiatrist, and their care would be returned to their family doctor with care focused on maintaining treatment gains and monitoring for setbacks.

So they’d be getting the appropriate set of services for ADHD. What can be missing, however, is systematic screening over time for other kinds of difficulties. For example, even though a young person might be at a statistically higher risk for developing psychosis symptoms, they would not necessarily be monitored for these. And I wouldn’t want to alarm anyone – the risk of developing severe psychosis is still very low. With this study, we’re hoping to monitor a group of approximately 200 kids with diagnosed mental health problems like disruptive disorders, keep track of how they do over time and ideally identify specific red flags associated with psychosis.

How would the ability to spot the signs of psychosis early change the quality of care?

Aristotle Voineskos: Psychosis symptoms can have devastating repercussions for the individual, his or her family and others. School performance goes down. They can become socially isolated, and have increased suicidal thinking and more. We know that the longer psychosis goes on without being treated, the greater the adverse impact on that person’s life.

So early identification makes a big difference in how these people do. We thought it would be important to understand which young people already getting mental health care for issues that emerge earlier in life such as autism, ADHD, or depression have elevated risk for psychosis symptoms.

And we’re wondering if effective care for young people with those other conditions might in fact reduce the negative effects or eliminate the chance of experiencing symptoms of psychosis altogether.

What do you hope this research will ultimately achieve?

Joanna Henderson: Ultimately we hope that any new insight into early signs of psychosis will help us build a better model of care. Our approach is focused on partnering and collaborating with different health-care teams and building capacity in the system – and these closer ties are important as we try to fill in some of the gaps in care, especially with this transition age group.

We’ll be working closely with the clinical services within the Child, Youth and Emerging Adult Program, such as the Autism Clinic and our clinical research centres at CAMH – I’m the director of the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, and Aristotle is director of the Slaight Family Centre for Youth in Transition.

The transition period is a time associated with greater mental health issues and substance use so there’s a major need for us to build bridges between services and provide ongoing support, especially for the most vulnerable youth.

Quitting smoking? Read this first

sgupta — Tue, 13 Jan 2015 12:27:47 +0000

Quitting smoking? Read this first sgupta Tue, 01/13/2015 - 07:27

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(photo by Włodi via Flickr)

Michael Kennedy

Author legacy

Michael Kennedy

Topic

Breaking Research

Alzheimer's, mood disorders: �鶹��Ƶ partners with industry for open source collaboration

sgupta — Wed, 12 Nov 2014 08:13:16 +0000

Alzheimer's, mood disorders: �鶹��Ƶ partners with industry for open source collaboration sgupta Wed, 11/12/2014 - 03:13

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Professor Ruth Ross, director of the Centre for Collaborative Drug Research (photo by Rick Chard/CAMH)

Liam Mitchell

Author legacy

Liam Mitchell

Health

Sunnybrook

St. Michael's Hospital

Subheadline

Working with Johnson and Johnson Innovation and Janssen to find neuroscience therapies

A new collaboration aimed at developing therapies for mood disorders and Alzheimer’s disease – known as the Neuroscience Catalyst – launched on November 6.

The new public-private partnership brings together the University of Toronto with Janssen Inc. and the Johnson & Johnson Innovation Center in California to support collaborative, open-source research.

“Mood disorders and Alzheimer’s disease are chronic illnesses that affect millions of people worldwide,” said Catharine Whiteside, �鶹��Ƶ’s dean of medicine and vice-provost, relations with health care institutions. “By 2040, these debilitating brain diseases could surpass cancer as the second-leading cause of death.

“Finding solutions that bring relief to those who face these aliments, and the family and friends who care for them, are what makes this partnership so important.”

Researchers at �鶹��Ƶ and its affiliated hospitals through the Toronto Academic Health Science Network (TASHN) are welcome to submit collaborative proposals. Scientists from Janssen will work with �鶹��Ƶ researchers to provide the drug-discovery expertise required to rapidly develop new medicines from basic science innovations. The open nature of the research means the findings can be published and researchers are free to commercialize their work with any company they wish.

The Neuroscience Catalyst is based at the Centre for Collaborative Drug Discovery (CCDR), which is a multidisciplinary initiative bringing together researchers from �鶹��Ƶ’s Faculty of Medicine, the Leslie Dan Faculty of Pharmacy and the Centre for Addiction and Mental Health (CAMH).

“There is a tremendous amount of incredible blue sky, curiosity-driven research being conducted at �鶹��Ƶ,” said Ruth Ross. The Centre’s inaugural director, Ross is a professor and chair of toxicology and pharmacology in the Faculty of Medicine and senior scientist with the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH).

"When we launched the CCDR, we began by looking across the fields of research in Toronto and asked ‘Where is there an opportunity and a need for us to add real impact in drug discovery?’”

Neuroscience is one area where Ross and partners saw CCDR could help to create a collaborative network to accelerate the translation of bench research into new treatments. In addition to the Neuroscience Catalyst, there will be other venues for researchers to share information and meet as a community.The first meeting will be held on November 27 when the Centre hosts Neuroscience Research Day on New Targets in Neurodegeneration and Neuropsychiatry.

Ross said the focus in neuropsychiatry and neurodegeneration highlights the “…urgent and compelling need for scientists, government and industry to work together in partnership, using their collective expertise to seek safe effective new interventions for debilitating conditions such as depression and Alzheimer’s disease.”

The Neuroscience Catalyst is overseen by a joint steering committee with representatives from �鶹��Ƶ, CAMH, St. Michael's Hospital, Sunnybrook Hospital, University Health Network and Janssen Inc. Ross believes the partnership is an example for future open innovation consortia with additional industry partners.

Liam Mitchell is a writer with the Faculty of Medicine at the University of Toronto.

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Back to School: how to calm students' stress and anxiety

sgupta — Mon, 08 Sep 2014 10:16:00 +0000

Back to School: how to calm students' stress and anxiety sgupta Mon, 09/08/2014 - 06:16

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Parents shouldn't dismiss a child's fears or pile on reassurances, experts say. Instead, help students learn to manage their fears.

Heidi Singer

Author legacy

Heidi Singer

Back to School

Medicine

Kids

Hospital for Sick Children

Education

CAMH

Features

The heavy academic pressures so common today raise back-to-school stress like never before – and it’s not just high school seniors or university students who are feeling it right now.

“It’s very sad to hear an eight-year old say ‘if I don’t get an A on this book report, I’m not going to university,” says Sandra Mendlowitz, assistant professor of child psychiatry at the University of Toronto's Faculty of Medicine. “We live in a very different world today, and children are facing all kinds of new pressure. Information overwhelms them. They’re overexposed.”

Parents can do a lot to help ease their children’s anxieties around school, she says. The key is to really listen, and let your child open up about their fears.

“You engage in a conversation when you’re not distracted by other things,” she says. “With younger children, you need to ask them specific questions that jog their memory. Ask what their teacher is like, not how their day was. If teens refuse to talk about their day, you could say, ‘Oh, sounds like something really juicy happened!’”

Performance aside, kids worry most about whether their teacher is friendly, and whether they will have a friend in the class, says Mendlowitz, who works on the anxiety disorders team at the Hospital for Sick Children. Younger children worry about whether their parents will be there to pick them up. Older kids might be anxious about whether their clothes or lunch will look weird to others. Parents shouldn’t dismiss their fears, but they should also resist the urge to pile on reassurance. Instead, help the child develop true confidence by thinking together about their fears and learning how to manage them. Work with the child on a plan to address the problem.

That’s also true for the college crowd, according to David Wolfe, a professor of psychiatry at �鶹��Ƶ and director of the centre for prevention science at CAMH. “Avoid helicopter parenting,” he advises, because hovering, overprotecting parents make it tough for kids to grow and become independent. That said, those newly independent university students probably do need help with time and money management, he notes – which means helping them develop a plan to manage their money, not just giving them more.

Showing your child how you solve problems is also a great solution, says Mendlowitz. “You could say, I had a great day except for one thing, and here’s how I managed it,” she advises.

And talking to your child’s teacher is also key, she adds. “It may be simply that the child is very uncomfortable with their seat mate. Or sometimes they’re too shy to ask for help, and the teacher needs to check in with them.”

If the parent shows anxiety, the child will likely pick up on this and become insecure, Mendlowitz warns. Parents should be aware of their own anxious signals: a high-pitched voice, asking the child if they’re okay too many times, or placing too much focus on the what-ifs.

“It’s never just one thing,” she says. “It’s the constellation of many different factors coming together that make a difference between whether your child is going to have a good or a difficult school year.”

Heidi Singer is a writer with the Faculty of Medicine at the University of Toronto.

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Understanding the depressed mind: how the brains of new mothers may hold the keys to treatment

sgupta — Fri, 15 Aug 2014 11:38:12 +0000

Understanding the depressed mind: how the brains of new mothers may hold the keys to treatment sgupta Fri, 08/15/2014 - 07:38

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Dr. Jeffrey Meyer uses brain imaging technology to detect elevated levels of chemicals in the brains of those with depression (photo by Christopher Wahl)

Dana Yates

Author legacy

Dana Yates

Topic

Subheadline

Dr. Jeffrey Meyer on what we can learn from postpartum depression

The death of award-winning actor and comedian Robin Williams has put depression and mental health issues back in the headlines.

Scientist Jeffrey Meyer of the University of Toronto and CAMH conducts research into depression and the brain. In this profile from Edge, a publication of �鶹��Ƶ's Office of the Vice-President, Research and Innovation, Meyer discusses his research into the role of an enzyme called MAO-A and his work to devise interventions that would help prevent depression in anyone from new mothers to the general population.

Depression is a disorder of many names. Winston Churchill, for example, called his depressive episodes the “black dog.” Others, meanwhile, refer to the condition as the blues or the blahs. Despite the colloquialisms for depression, the reality is the disease can feel like a dark, endless tunnel — one that researcher Jeffrey Meyer hopes to prevent people from entering.

Meyer, an MD/PhD and professor in the University of Toronto’s departments of Psychiatry, and Pharmacology and Toxicology, is head of neurochemical imaging for the Mood and Anxiety Disorders program at the Centre for Addiction and Mental Health (CAMH). Also the Canada Research Chair in Neurochemistry of Major Depressive Disorder, Meyer is focused on answering one question: what is needed to have a healthy brain?

To that end, Meyer wants to create specific recommendations to help people sidestep major depressive disorder. Typically just called depression, the condition is much more than a brief period of melancholy — it involves ongoing feelings of deep despair.

“Ultimately, we would like to say, ‘Here are four things you should do to avoid depression',” Meyer said. “It would be similar to the strategies for avoiding heart disease, which include eating right and exercising, but in the case of depression, the strategies would be more complicated than simply saying ‘avoid stress'.”

That advice could have a significant impact on mental health worldwide. Indeed, depression affects more than 350 million people globally, according to the World Health Organization. While there are treatments for the condition, such as medicine, therapy and lifestyle changes, they don’t seem to work for everyone. And at its worst, depression can lead to suicide. In fact, one million people take their own lives each year around the world.

So what happens in depressed brains? Meyer is focused on monoamine oxidase A (MAO-A), an enzyme that breaks down the chemical messengers serotonin, dopamine and norepinephrine. When the brain is depleted of those mood-related substances, people experience a sad emotional state. And those feelings, along with pessimism, are harbingers of depression.

Although scientists long believed that a chemical imbalance in the brain caused depression, in 2006 Meyer and his colleagues determined conclusively how that process actually works. Using a brain imaging technique called positron emission tomography, the researchers found that the level of MAO-A was considerably higher in the brains of those with untreated depression. Meyer subsequently made other landmark discoveries. For instance, he found that MAO-A is elevated in several high-risk states for clinical depression, including prior to the condition’s recurrence, during early withdrawal from heavy cigarette smoking and just after childbirth.

Today, Meyer is using that information to study and assist those with high MAO-A. For example, he has developed a natural health product to help regulate the MAO-A of new mothers with postpartum depression. After giving birth, a woman’s estrogen level drops considerably, triggering a surge in MAO-A level.

"We have developed a measure of postpartum blues that can be used to screen combinations of ingredients in the supplement," said Meyer. "Postpartum blues is the healthy range sadness that tends to peak on day five postpartum and when severe is associated with later clinical level postpartum depression.

"If we reduce postpartum blues we hope to reduce risk of postpartum depression. We are now piloting the supplement to see to what extent it reduces severity of postpartum blues."

It would still be a few years before the product might reach the market. Meyer is now testing the dietary supplement on new mothers in an open trial (where all patients receive the supplement) and the next step would be to test the product in a randomized, double-blind trial.

Meyer also aims to develop interventions to adjust the MAO-A of people at increased risk of depressive symptoms, including premenopausal women and those with substance addiction. As well, on top of designing preventive strategies to help the general population avoid depression, Meyer hopes to bring peace of mind to those with the treatment-resistant form of the disorder. That two-step process will involve identifying subtypes of depression and determining which treatments best normalize brain changes in each subtype.

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