December 2023

As I reflect on the work of CAMH's scientists, trainees and research staff over the past year, there is much to be proud of! In 2023, the Research Institute continued to make significant progress with implementing goals of its Research Workplan, and the Clinical Trials Unit and the Koerner Centre for Research Training were launched. A number of investments have also been made to support equity, diversity and inclusion goals including 8 Research Application Support Initiative (RASI)) scholarships for summer trainees from equity seeking groups; $145,000 in new awards from the Koerner Centre for graduate students and post-doctoral fellows from under-represented groups; and soon to be launched grants focused on Black and Indigenous research and researchers. Please enjoy this month's issue of brainbuzz™ featuring recent research findings and news coming out of CAMH. Happy holidays and best wishes for 2024!

Aristotle Voineskos
VP Research, CAMH
 

CAMH study finds that youth sports participation may mitigate genetic risk
for mental illness

Study of nearly 5,000 nine- and 10-year-olds suggests playing non-contact or team sports may reduce problematic behaviours and symptoms in youth at risk for OCD

A new Centre for Addiction and Mental Health (CAMH) study has found an association between youth participation in non-contact or team sports and a reduction in behavioural and social problems, and suggests that more frequent participation may improve behaviour for a child who is genetically at risk for obsessive compulsive disorder (OCD).

The article, entitled Interactions between genetic risk for 21 neurodevelopmental and psychiatric disorders and sport activity on youth mental health, led by first author CAMH Research Analyst Melissa Misztal and senior author Dr. Daniel Felsky, Scientist at the Krembil Centre for Neuroinformatics, has been published in the journal Psychiatry Research.

The study analyzed a subset of data for 4,975 children aged nine and 10 who participated in the ongoing Adolescent Brain and Cognitive Development (ABCD) Study, the largest long-term study of brain development and child health in the United States. The study is funded by the U.S. National Institutes of Health (NIH) and shares its data with researchers globally.

All of the children participating in the study provided saliva samples and underwent polygenic risk score analysis to assess their genetic risk for 21 forms of mental illness, including OCD.  They were also assessed using a standard checklist for signs of 8 common behavioural and social problems in children (including anxiety, attention problems, and rule-breaking behaviors) that are associated with a higher risk for developing mental health conditions as they get older. All of the participating children also filled out extensive questionnaires about other aspects of their lives, including participation in sports.

The study found that children who took part in non-contact or team sports (such as soccer, basketball or water polo) had fewer problematic symptoms in all categories than children who did not participate in these types of sports. The greater the frequency of participation, the greater the benefit to youth mental health. However, those participating in individual sports (such as gymnastics, skateboarding or tennis) had fewer differences in symptoms, and those participating in contact sports (including football, ice hockey and wrestling) had higher levels of rule-breaking behaviours. 

“Children who participated in non-contact or team sports had on average lower problematic symptoms across the board in every domain we examined,” said Dr. Daniel Felsky. “They had fewer attention problems, fewer thought problems, fewer withdrawn and depressed symptoms and fewer rule-breaking behaviours.” 

While it has been established that team sports participation in young people can improve psychological wellbeing and reduce risk of developing mental illness, no previous studies have examined this relationship in the context of genetic risk over time. “Not only did we identify previously unobserved associations between sports participation and problematic symptoms in this population, but crucially we tested if these associations changed for children with different genetic risk profiles. For children at high genetic risk for OCD, we found this was the case.”

Previous studies have found that physical activity promotes the growth of new neurons in the brain, a process known as ‘neurogenesis’ that has beneficial effects on cognition and reasoning.  It also produces secretions of serotonin in the brain. The authors speculate that since OCD is associated with serotonin deficiencies, physical activity may have a uniquely protective effect on the brain for children with a genetic risk for OCD.

This study is part of Dr. Felsky’s overall work in the emerging field of “whole person modelling” that looks at the intersection of biological, psychosocial and environmental factors in the research, diagnosis and treatment of mental illness. 

Dr. Felsky says that this study raises another possibility, that some mental illness could be prevented in young people with a genetic risk for OCD and possibly other forms of mental illness: “A key finding here is relevant to concerned parents whose child has a higher genetic risk for OCD and possibly other psychiatric disorders; these data suggest that even with a high genetic risk profile, frequent participation in sports may reduce that risk. This information can be really helpful to public policy-makers as sports participation in schools is a fairly low-cost, low-hanging fruit which appears to provide extensive benefits for mental wellness.”
 

Cannabis use during pregnancy associated with adverse birth outcomes

Meta-analysis examined outcomes of nearly 60 studies conducted over 40 years

A meta-analysis of studies published over the past 40 years on cannabis use during pregnancy has found an association between fetal exposure to cannabis in the womb and preterm delivery, low birth weight and the need for neonatal intensive care admission (NICU).

The study, Birth, Cognitive and Behavioural Effects of Intrauterine Cannabis Exposure in Infants and Children: A Systemic Review and Meta-Analysis, was published today in the journal Addiction. 

Previous research has indicated that THC, the main psychoactive component in cannabis, can cross the placenta to the fetus during pregnancy and bind to receptors in the fetal brain.

The meta-analysis examined the results of 57 studies around the world that included almost 13 million infants in total.  Based on either self-reports from pregnant women, or blood and saliva testing depending on the study, just over 100,000 infants were found to be exposed to cannabis in the womb. While none of the studies found a direct causal relationship between cannabis use during pregnancy and adverse birth outcomes, the combined results indicated that newborns exposed to cannabis during pregnancy were twice as likely to require NICU admission, twice as likely to have a low birth rate and one and a half times more likely to be born early.

While there has been little research on cannabis use during pregnancy since cannabis was legalized in Canada five years ago, an American study has indicated an increase in cannabis use during pregnancy in states where it has been legalized and the perceived risk of harm from cannabis has decreased. The study states that overall cannabis use in pregnancy has doubled in the past 20 years, with approximately 10 per cent of pregnancies associated with cannabis exposure. Some studies indicated it was being used to alleviate symptoms of nausea, poor appetite, insomnia or anxiety during pregnancy.

Canada’s Lower Risk Cannabis Use Guidelines, developed by a nationwide team led by CAMH scientists, recommends cannabis abstinence during pregnancy.

“This research emphasizes the importance of healthcare providers making an effort to create a safe space talking to pregnant women and women planning to be pregnant about their cannabis use and their motivations for using it to educate them about the potential risks and empower them to make informed decisions for their child,” says lead author Maryam Sorkhou, a PHD student within the addictions division at CAMH as well as the University of Toronto. Ms. Sorkhou is overseen at CAMH by Senior Scientist and paper co-author Dr. Tony George.

Funding for the study was provided by the CAMH Discovery Fund.
 

One in three workers supporting people with developmental disabilities report
moderate to severe distress

A province-wide mental health survey recently conducted by the Azrieli Adult Neurodevelopment Centre at CAMH has found that 35 per cent of Direct Support Professionals (DSPs) are reporting moderate to severe levels of distress.

The Azrieli Centre has been following the mental health of staff in the sector since the start of the pandemic, and this new report confirms that levels of staff distress have continued to rise over the last two years.

In this latest survey conducted in the summer of 2022, 868 DSPs took the time to share important concerns regarding their mental health, the mental health of those they support, as well as current stressors. 

The report lists several factors that may be contributing to higher levels of pandemic-related mental distress among DSPs, including:

• Pandemic pressures at work. These include ongoing staff shortages, longer hours and lack of time off.
• Structural and system challenges. These include low pay, unpaid sick time and lack of benefits. Infection prevention and control procedures. These include increased fears about risk of exposure to COVID-19 in the community and frustration regarding a perceived lack of public concern regarding the more vulnerable clients they work with.
• Impact of the pandemic on the health and well-being of people with developmental disabilities. These include poor mental and physical health, decrease in quality of life, long-term effects of not seeing family and friends, decline in independence and feelings of compromised care due to staffing shortages.
• Barriers to seeking their own mental health supports. Nearly half of DSPs (49 per cent) reported barriers to accessing mental health supports for themselves, including financial barriers, lack of time to seek supports and stigma.

“The combination of more difficult working conditions and staff shortages, plus greater distress among the clients they support, has made this an exceedingly difficult time for Direct Support Professionals on the front lines” says Dr. Yona Lunsky, Director of the Azrieli Centre and Senior Scientist at CAMH. “To promote the health and well-being of this essential workforce, it is critical to address the unique needs of DSPs as well as the people with developmental disabilities they support.”

Previous studies have found that people with developmental disabilities are at greater risk of contracting COVID-19 and dying from it, and are nearly four times as likely to die prematurely from all causes than the general population. Some of the DSPs who took part in the survey indicated that increased work stress due to the pandemic was making it more difficult to provide for the health and wellness need of their vulnerable clients.

“Providing good quality supports on any day can be challenging,” said one respondent. “Most days are very good. However, that wears very thin when staff are working 12- or 13-hour shifts, day after day after day…morale becomes low and that is seen by the people we support. Care is always provided, but perhaps not done with a smile due to fatigue and exhaustion.”

“I got serious burnout and ended up crying to my scheduling manager,” said another. “I wish that people realized that everyone has a breaking point and it’s important to catch it before it happens to staff.  Look at the signs and train your employees to recognize it in each other.”

These stories, along with the information that DSPs have shared about their mental health, provide important insights from the front line. This knowledge will be used to inform critical next steps to address the mental health needs of all those that work and receive supports in the developmental services sector. This includes advocating for greater access to the same mental health supports and resources available to other professionals working in health and long-term care.

“Navigating the global pandemic through execution of intensive infection control supports has been daunting in demand and it has been compounded by some of the most critical staffing shortages in our history.” says Michelle Brooks, Executive Director of The Participation House Project in Durham Region, and Chairperson of The Provincial Network on Developmental Services. “The significant toll on our frontline caregivers and our leadership teams has given way to unprecedented occurrences of burnout and depletion of resilience in both people and care giving teams. As we continue to collaborate and develop resources, we are taking pause to review and reflect on the feedback gathered through this survey. The voices of many will help inform how we can grow our efforts and help others create environments where people can come together, support each other and begin to heal.”

You can read the full report here.

This report builds on findings are among the findings of a province-wide mental health survey of 868 DSPs conducted in July 2020. Learn more about that previous survey and other related documents here.
 

Buzz-worthy News

• On November 30th, the groundbreaking 9-8-8 national suicide crisis helpline was launched. The initiative was led by CAMH and Dr. Allison Crawford joined CTV News to talk about this important Canadian milestone.
  https://twitter.com/CAMHnews/status/1730659540482371959
• CAMH Drs. Mahavir Agarwal & Margaret Hahn are currently exploring whether semaglutide, a common diabetes treatment, can reduce body weight and improve mental health for individuals receiving treatment for schizophrenia.
  https://twitter.com/CAMHResearch/status/1727436743476150622
• SAVE THE DATE! We have much to discover in the world of women’s mental health. Mark your calendars on April 17-18, 2024, for the first-ever womenmind™ Conference exploring breakthrough science and unite in advocacy to advance this field of research. More info to come!
  https://twitter.com/CAMHnews/status/1731718113974980779