[Diabetes, loved ones: Constraints, support, shared experiences]. / Le diabète et les proches, entre contraintes, soutien et vécus en commun.

Diabetes is a pathology that has major consequences not only for those who suffer from it, but also for those around them. Relatives can play different roles in this respect, depending on the type of relationship they have with the person with diabetes. The onset of the disease is likely to modify pre-established roles within social groups such as the family sphere, with the possibility of strengthening ties, but also of damaging them.

French national helpline "stop" for minor-attracted persons: First findings.

OBJECTIVES: Preventing minor-attracted persons from acting on their impulses is a significant public health concern. To address this, the STOP telephone helpline was established nationwide in France in January 2021. This service acts as a bridge, connecting callers with their nearest CRIAVS (resource centers for professionals working with sex offenders) where they can speak with a healthcare professional who can guide them toward appropriate care if needed. Our study is a detailed look at the STOP service's activity from January 1st, 2021, to December 31st, 2022, covering a span of 24 months. METHOD: We developed a structured approach to collecting data for analysis. Data were extracted from the centralized database of the STOP service, allowing for the collection of quantitative variables and qualitative variables. RESULTS: Over the study period, there were 5442 calls made to the service. After filtering out calls that were unsuccessful or too short (mostly under 5minutes), we analyzed 369 records. Among these, 79.1% were first-time callers, with 73.3% of them admitting to being attracted to children, a group which predominantly consisted of men. Notably, 46.7% of callers expressing an attraction to children were referred to further care. In total, 72.6% of callers learned about the service through media channels. CONCLUSION: Analysis revealed that the STOP service was primarily utilized by the intended audience-minor-attracted persons. The gradual decline in call volume over time and the reliance on media for awareness highlight the importance of widespread publicity. The findings from our study, spanning twenty-four months of the STOP service's operation, highlight the value of having such a platform available to facilitate access to mental health support for minor-attracted persons. They emphasize the need for increased communication efforts to promote the STOP service and call for further data analysis to enhance its effectiveness.

Aging and Mental Health: Collaborating on Research Priorities with Older Adults, Caregivers and Health and Social Care Providers across Canada.

Age-related changes can affect mental health, but aging-focused mental health research is limited. The objective was to identify the top 10 unanswered research questions on aging and mental health according to what matters most to aging Canadians. A steering group of experts-by-experience (e.g., older adults, caregivers, health and social care providers) guided three phases of a modified James Lind Alliance priority-setting partnership: (1) a broad national survey (n = 305) and a rapid literature scan; (2) a follow-up national survey (n = 703); and (3) four online workshops (n = 52) with a nominal group technique. Forty-two unique questions on aging and mental health resulted, of which 18 were determined to be answered by existing evidence. Of the 25 partially and unanswered questions, 10 were ranked as top priority. Findings can be used to prioritize future research, knowledge mobilization, and funding decisions, and to promote and support collaboration between longstanding siloed research and care fields.

La pharmacothérapie en fonction des gènes chez les enfants et les adolescents qui prennent des médicaments psychoactifs.

Les médicaments psychoactifs sont de plus en plus utilisés pour traiter les enfants et les adolescents ayant des troubles de santé mentale, mais la variabilité des réponses individuelles fait ressortir l'importance d'une médecine personnalisée. Les tests pharmacogénétiques sont un volet important d'un tel type de médecine. Le nombre d'entreprises de tests pharmacogénétiques commerciaux qui font la promotion de tests de ce genre et promettent un traitement efficace et individualisé des troubles de santé mentale se multiplie depuis quelques années. Les preuves scientifiques en appui à l'utilisation de la pharmacogénétique sont limitées, particulièrement dans les populations pédiatriques. Le présent point de pratique souligne les étapes qui orientent le recours à ces tests pour la prise de médicaments psychoactifs en milieu clinique et présente des ressources de soutien importantes. Il existe des directives cliniques sur les variants des pharmacogènes qui encodent les enzymes de métabolisation du cytochrome P450 (p. ex., CYP2C19, CYP2D6, CYP2C9), lesquels sont l'un des déterminants des concentrations pharmacologiques dans le sang et peuvent appuyer à la fois le choix du médicament et la stratégie posologique de certains antipsychotiques, antidépresseurs et antiépileptiques. Les effets indésirables de certains médicaments antiépileptiques (p. ex., la carbamazépine et la phénytoïne) sont associés à certains types d'antigènes d'histocompatibilité humaine et à des variants de l'ADN polymérase gamma (POLG; acide valproïque). Les données probantes sont limitées à l'égard des variants génétiques des protéines qui ciblent les médicaments, et c'est pourquoi il est difficile de déterminer quels patients présenteraient une réponse altérée au traitement à une concentration sanguine thérapeutique.

[Psychological stress and the need for stress management in veterinary studies]. / Psychische Belastung und die Notwendigkeit von Stressmanagement im Veterinärmedizinstudium.

INTRODUCTION: Veterinary students suffer from increased psychological stress compared to the general public and are increasingly affected by manifest mental illnesses such as depression and anxiety disorders, as well as an increased prevalence of suicidal thoughts. Additionally, veterinary students tend to ignore signs of mental distress and do not seek support for their mental health issues. This impaired mental health is also evident in fully trained veterinarians, who, among other things, have the highest suicide rates of all medical professions. In our survey, we examined a total of 428 veterinary students at the two veterinary faculties of the Universities of Zurich and Bern. The survey was carried out across all six years of the curriculum as a cross-sectional survey using standardized questionnaires on resilience, sense of coherence and depression. In all years, the students showed increased levels of depression compared to the general public, and the salutogenic parameters of resilience and sense of coherence were also reduced. The constellation with increased depression, reduced resilience and reduced sense of coherence was particularly accentuated in the second and third year. The increased affective stress on students presents itself as a consistent condition, which - if you look at studies on fully trained veterinarians - continues into their working life together with a reduced ability to cope. The low number of participants in the higher years of study and the high number of female study participants could limit the generalizability of the results. In addition, the data was collected in spring 2021 during the COVID-19 pandemic, which may have influenced the results. Active counteracting, for example by integrating the teaching of protective behavior such as mindful self-compassion and resource-oriented behavior such as mind-body techniques, therefore appears to be recommended in the veterinary training curriculum from the first semester onwards. Various measures to support students have been introduced since 2021, such as events on learning strategies, a mentoring system and seminars on mental health.

INTRODUCTION: Les étudiants en médecine vétérinaire souffrent d'un stress psychologique plus important que le grand public et sont de plus en plus touchés par des maladies paychiques manifestes telles que la dépression et les troubles anxieux, ainsi que par une prévalence accrue de pensées suicidaires. En outre, les étudiants en médecine vétérinaire ont tendance à ignorer les signes de détresse mentale et ne cherchent pas de soutien pour leurs problèmes de santé mentale. Cette détérioration de la santé mentale est également évidente chez les vétérinaires formés, qui, entre autres, présentent les taux de suicide les plus élevés de toutes les professions médicales. Dans notre enquête, nous avons examiné un total de 428 étudiants vétérinaires des deux facultés vétérinaires des universités de Zurich et de Berne. L'enquête a été menée sur les six années du cursus sous forme d'enquête transversale à l'aide de questionnaires standardisés sur la résilience, le sentiment de cohérence et la dépression. Pour toutes les années, les étudiants ont montré des niveaux de dépression plus élevés que le grand public, et les paramètres salutogènes de la résilience et du sentiment de cohérence ont également été réduits. La constellation avec une dépression accrue, une résilience réduite et un sentiment de cohérence réduit était particulièrement accentuée en deuxième et troisième année. Le stress affectif accru des étudiants se présente comme un état constant qui, si on examine les études sur les vétérinaires ayant reçu une formation complète, se poursuit dans leur vie professionnelle, accompagné d'une capacité réduite à faire face. Le faible nombre de participants dans les années d'études supérieures et le nombre élevé de participantes à l'étude pourraient limiter la généralisation des résultats. En outre, les données ont été collectées au printemps 2021, pendant la pandémie de COVID-19, ce qui a pu influencer les résultats. La lutte active, par exemple en intégrant l'enseignement d'un comportement protecteur tel que l'autocompassion consciente et d'un comportement orienté vers les ressources tel que les techniques corps-esprit, semble donc être recommandée dans le programme de formation vétérinaire dès le premier semestre. Diverses mesures de soutien aux étudiants ont été introduites depuis 2021, telles que des événements sur les stratégies d'apprentissage, un système de mentorat et des séminaires sur la santé mentale.

[Young people, a key target]. / Les jeunes, une cible déterminante.

Health determinants, whether direct (e.g. behavior) or indirect (e.g. environment), have an impact on the health status of the population. In this article, we look at the influence of some of these parameters on young people, a key target group for the future.

Comparing the Efficacy of Electronically Delivered Cognitive Behavioral Therapy (e-CBT) to Weekly Online Mental Health Check-Ins for Generalized Anxiety Disorder-A Randomized Controlled Trial: Comparaison de l'efficacité de la thérapie cognitivo-comportementale délivrée par voie électronique (e-TCC) aux contrôles hebdomadaires en ligne de santé mentale pour le trouble d'anxiété généralisée - un essai randomisé contrôlé.

BACKGROUND: Generalized anxiety disorder (GAD) is a prevalent anxiety disorder characterized by uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is one of the first-line treatments that has demonstrated high efficacy in reducing symptoms of anxiety. Electronically delivered CBT (e-CBT) has been a promising adaptation of in-person treatment, showing comparable efficacy with increased accessibility and scalability. Finding further scalable interventions that can offer benefits to patients requiring less intensive interventions can allow for better resource allocation. Some studies have indicated that weekly check-ins can also lead to improvements in GAD symptoms. However, there is a lack of research exploring the potential benefits of online check-ins for patients with GAD. OBJECTIVE: This study aims to investigate the effects of weekly online asynchronous check-ins on patients diagnosed with GAD and compare it with a group receiving e-CBT. METHODS: Participants (n e-CBT = 45; n check-in = 51) with GAD were randomized into either an e-CBT or a mental health check-in program for 12 weeks. Participants in the e-CBT program completed pre-designed modules and homework assignments through a secure online delivery platform where they received personalized feedback from a trained care provider. Participants in the mental health check-in condition had weekly asynchronous messaging communication with a care provider where they were asked structured questions with a different weekly theme to encourage conversation. RESULTS: Both treatments demonstrated statistically significant reductions in GAD-7-item questionnaire (GAD-7) scores over time, but when comparing the groups there was no significant difference between the treatments. The number of participants who dropped out and baseline scores on all questionnaires were comparable for both groups. CONCLUSIONS: The findings support the effectiveness of e-CBT and mental health check-ins for the treatment of GAD. PLAIN LANGUAGE SUMMARY TITLE: Comparing the Effectiveness of Electronically Delivered Therapy (e-CBT) to Weekly Online Mental Health Check-ins for Generalized Anxiety Disorder-A Randomized Controlled Trial.

Generalized anxiety disorder (GAD) is a prevalent psychiatric condition that leads to symptoms like uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is a common psychotherapy used for GAD since it has been shown to reduce symptoms. However, traditional CBT that is in person can have barriers such as being inaccessible and costly, and therefore electronically delivered CBT (e-CBT) is a viable alternative since previous studies have shown its efficacy in reducing symptoms and being similar compared to face-to-face CBT. Previous studies have also shown reductions in GAD symptomology through the use of checking in on people and their mental health. Therefore, this study aimed to compare e-CBT to a check-in condition and had a total of 45 individuals in e-CBT and 51 participants in the check-in condition. Participants in the e-CBT condition completed 12 weeks of predesigned e-CBT modules, homework and received personalized feedback from a care provider. In contrast, individuals in the check-in condition completed 12 weeks of unstructured asynchronous messaging with a care provider. Results from the study showed that both the e-CBT and check-in condition demonstrated statistically significant improvements in GAD-7 across time, but when comparing the groups there was no significant difference. The results show the efficacy of e-CBT and checking in on people's mental health to reduce GAD and future research should examine the 2 conditions combined.

[Portrait of an IPA PSM specialising in suicide prevention]. / Portrait d'un IPA PSM spécialisé en prévention du suicide.

Suicide prevention is a major public health issue, both nationally and internationally. The management of suicidal patients leaving emergency departments is crucial to preventing the risk of suicidal recurrence. Advanced practice nurses in psychiatry and mental health can provide real added value thanks to their specialist training, their ability to carry out a comprehensive and detailed clinical assessment, their mastery of medicinal and non-medicinal therapeutic interventions, their skills in coordinating the various players involved in the care pathway, their commitment to prevention and their skills in supporting the development of the skills of care and research teams.

Psychological impact of the end of lockdown on the Moroccan population.

This work is a descriptive cross-sectional study that aimed to assess by means of an online survey the well-being and psychological impact, mainly depression, anxiety, stress and post-traumatic stress disorder (PTSD), experienced by the general population after the end of lockdown following the COVID-19 pandemic. In this study, we used the PCL-S scales to assess PTSD and the DASS scale to assess depression, anxiety, and stress related to end of quarantine. Our study found that following the decontamination related to COVID-19, the psychological impact was not negligible with a significant prevalence of occurrence for several psychological disorders. We found depression (68.8%), anxiety (57.47%), stress (45.50%) and post-traumatic stress disorder (31.5%) in the subjects of our study. Following the decontamination related to COVID-19, the psychological impact was found to be as important or even more serious than the other situations that preceded it. The development of a database allowing us to understand the effect of the decontamination on the mental health of Moroccans could be useful in order to watch and prevent the occurrence of complications for psychological disorders such as depression, anxiety, stress or even a state of post-traumatic stress.

Exploring Food Security and Mental Health Among Street-Involved Canadian 2S/LGBTQI+ Youth: A Review of the Literature.

The purpose of this literature review is to evaluate the extant research addressing food insecurity and mental health among street-involved 2S/LGBTQI+ youth in Canada. Searches were undertaken in academic databases, Google, and Google Scholar for relevant research articles, reports, and grey literature. Our team found nil research specifically addressing food insecurity and the mental health of street-involved 2S/LGBTQI+ youth in Canada. Given that, contextual and contributory factors affecting the mental health and food security of this population are discussed. The available research demonstrates a significant misalignment between the existing support mechanisms and the requirements of this specific population. This underscores the urgent necessity for the establishment of structurally competent, safe, and easily accessible resources. Moreover, there is a clear imperative for additional research endeavors aimed at addressing knowledge deficiencies. These efforts are crucial in empowering dietitians to facilitate enhanced interdisciplinary collaboration, thereby fostering the creation of sustainable, accessible, and appropriate food systems tailored to the needs of this vulnerable demographic.

[Nutrition and mental health in athletes]. / Nutrition et santé mentale des athlètes.

In the world of top-level sport, optimising athletic performance does not rely solely on physical training. Taking into account the intestine-brain axis offers new ways of optimising sports preparation, partly thanks to the role of the intestinal microbiota on performance and well-being.

[A framework for the practice of peer support]. / Pour un cadre d'exercice de la pair-aidance.

The concept of peer support is now firmly established in the psychiatric landscape. While taking into account the benefits that this approach brings to patients and teams, it is essential to consider the need to define a framework for the practice of peer support. This framework, which is essential for the development of the practice, will help to avoid overly fragile exposure, which is synonymous with difficulties for peer helpers and their teams.

[The irresistible deployment of peer professionals in mental health]. / L'irrésistible déploiement des pairs professionnels en santé mentale.

Over the last fifteen years or so in France, the deployment of peer professionals in mental health seems to have accelerated. The benefits of peer support have been widely demonstrated. It is based on the experiential knowledge acquired by certain patients who have recovered during their course of treatment, which can be passed on by positive identification, stimulating hope and motivation. These unique skills are then complemented by more theoretical knowledge sanctioned by a diploma that legitimises the future professionals and gives them access to undisputed recognition to work alongside pre-existing systems. However, it is not always easy to integrate them into health and social teams.

The mental health of high school students returning to in-class lessons.

OBJECTIVES: It is known that lockdown alters the mental health of children in general and adolescents in particular. Here, we surveyed the mental health of high school students returning to in-class lessons after the pandemic. We compared an "anxious-depressed" group with a "neither anxious nor depressed" group with regard to perceived self-efficacy. METHODS: Students from a high school in the Rhône-Alpes region of France participated in a mental health survey. After the students had been given a study information sheet and had agreed to participate, they filled out three paper-based questionnaires the State-Trait Anxiety Inventory for Children (STAI-C), the Center for Epidemiological Studies-Depression (CES-D) self-questionnaire, and the Self-Efficacy Questionnaire for Children (SEQ-C) on an anonymous basis. RESULTS: A total of 709 datasets were analyzed. The participants' mean±standard deviation age was 15.89±0.93. The group comprised 438 girls, 251 boys, and 20 participants who did not state their sex. Compared with the boys, the girls had significantly higher scores in the STAI-C and CES-D questionnaires. According to the SEQ-C, the boys felt significantly more effective than the girls overall and for social efficacy and emotional efficacy. In contrast, the boys and girls did not differ regarding the academic efficacy score. Our main findings were that 53% (n=379) of the high school students were reportedly free of anxiety or depression, 28% (n=198) showed symptoms of subclinical anxiety and depression, and 19% (n=131) showed symptoms of clinical anxiety or depression. We compared the "anxious-depressed" group with the "neither anxious nor depressed" group: the former group was mainly composed of girls, whereas there were nearly as many boys as girls in the latter group. After adjustment for sex, the overall self-efficacy and the academic, social and emotional efficacy scores were found to be lower in the "anxious-depressed" group. The sex difference was null for social efficacy, small for overall efficacy and academic efficacy, and moderate for emotional efficacy. CONCLUSIONS: Overall, 47% of the study participants reported subclinical anxiety and/or a depression. It appears that anxiety and depression are linked to self-efficacy: the self-efficacy score was lower in the "anxious-depressed" group than in the "neither anxious nor depressed" group.

Computer-Based Training for Cognitive Behavioural Therapy for Substance Use Disorder: A Randomized Controlled Trial Including Quantitative and Qualitative Health and Economic Outcomes: Formation informatisée pour la thérapie cognitivo-comportementale pour les troubles liés à l'usage de substances : un essai randomisé contrôlé y compris les résultats quantitatifs et qualitatifs en matière de santé et d'économie.

OBJECTIVES: Heavy alcohol and drug use is reported by a substantial number of Canadians; yet, only a minority of those experiencing substance use difficulties access specialized services. Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT) offers a low-cost method to deliver accessible and high-quality CBT for substance use difficulties. To date, CBT4CBT has primarily been evaluated in terms of quantitative outcomes within substance use disorder (SUD) samples in the United States. A comparison between CBT4CBT versus standard care for SUDs in a Canadian sample is critical to evaluate its potential for health services in Canada. We conducted a randomized controlled trial of CBT4CBT versus standard care for SUD. METHODS: Adults seeking outpatient treatment for SUD (N = 50) were randomly assigned to receive either CBT4CBT or treatment-as-usual (TAU) for 8 weeks. Measures of substance use and associated harms and quality of life were completed before and after treatment and at 6-month follow-up. Qualitative interviews were administered after treatment and at follow-up, and healthcare utilization and costs were extracted for the entire study period. RESULTS: Participants exhibited improvements on the primary outcome as well as several secondary outcomes; however, there were no differences between groups. A cost-effectiveness analysis found lower healthcare costs in CBT4CBT versus TAU in a subsample analysis, but more days of substance use in CBT4CBT. Qualitative analyses highlighted the benefits and challenges of CBT4CBT. DISCUSSION: Findings supported an overall improvement in clinical outcomes. Further investigation is warranted to identify opportunities for implementation of CBT4CBT in tertiary care settings.Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03767907.

Evaluating a digital intervention targeting substance use difficultiesPlain Language SummaryWhy was the study done?Heavy alcohol and drug use is frequent in the Canadian population, although very few people have access to treatment. The digital intervention, Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT), may provide a low-cost, high-quality, and easily accessible method of treatment for substance use difficulties. Limited research on this digital intervention has been conducted in Canadian populations, and few studies thus far have evaluated participants' subjective experience using the intervention, along with the cost on the Canadian healthcare system.What did the researchers do?The research team recruited participants and provided access to either CBT4CBT or to standard care at a mental health hospital for 8 weeks. Participants were asked questions about their substance use and related consequences, quality of life, and thoughts on the treatment they received. Information regarding healthcare use and the cost to the healthcare system was also gathered.What did the researchers find?Participants in both groups improved with regards to their substance use, some related consequences, and psychological quality of life. Participants provided insight on the benefits and challenges of both types of treatment. It was also found that the CBT4CBT intervention was less costly.What do these findings mean?These findings support that adults receiving CBT4CBT and standard care both improved to a similar degree in this sample. Participant feedback may inform future studies of how best to implement this intervention in clinical studies. Future studies with larger samples are needed to further examine whether CBT4CBT can increase access to supports and be beneficial in the Canadian healthcare system.

Violent video gaming among French adolescents: Impact on mental health by gender.

BACKGROUND: Nowadays, video games are very popular among teenagers. This popularity generates concerns, whether in the media, among families or among the scientific community, who wonder about their potential harmful effects. The aim of this study was to assess the association between different types of use of video games (absence of use, use of violent video games, use of non-violent video games) and mental health and aggression. METHODS: Data was drawn from a French cross-sectional study entitled "Portrait d'Adolescents" which included 15,235 adolescents using anonymous self-administered questionnaires. We defined three groups of use of video games (absence of use, use of violent video games, use of non-violent video games) and explored the association with mental health indicators among boys and girls. RESULTS: The group categorized as "non-gamers" consisted of 1288 adolescents (8.5%), while the "non-violent video gamers" group comprised 8380 adolescents (55.5%) and the "violent video gamers" group included 5430 participants (36%). Among adolescent boys, there was no observed association between responses to mental health-related questions and the type of video game playing. However, in the "violent video gamers" group, a higher percentage of boys (6.8%) reported engaging in self-harm behaviors (p=0.001). In contrast, in the "non-violent video gamers" group, a lower proportion of boys (9.4%) reported participating in dangerous games (p<0.0001). For girls, the "violent video gamers" group exhibited a higher proportion of responses indicating poorer mental health across all explored items: 22.8% reported a history of suicide attempts (p<0.0001), 22.3% reported depression (p<0.0001), 17.8% reported self harm (p<0.0001), and 11.2% reported participating in dangerous game (p<0.0001). CONCLUSION: Violent video games appear to be associated with varying behaviors depending on the gender of adolescents, and notably contribute to much poorer mental health among adolescent girls.

The Association between Residential Environment and Self-Rated Mental Health among Older Canadians: The Moderating Effects of Education and Gender.

This study examined the associations between residential environment and self-rated mental health (SRMH) among Canadians aged 65 or older (n = 16,304) and whether education and gender moderated the associations. Data came from the 2018 Canadian Housing Survey. Hierarchical multiple regressions were conducted to test the associations. Analyses revealed that increased dwelling size was associated with better SRMH among older women with high school education. Older adults with higher satisfaction with their dwelling design were more likely to report better SRMH, except for women with some college education. Feeling safer in the community was uniquely associated with better SRMH for men with high school education and women with a university degree. Results confirmed significant associations between specific home and residential environment features and SRMH for each gender-by-education group. Environmental programs designed to improve SRMH for older adult populations should consider within- and between-group diversity.

[The subjective experience of contact with the deceased or necrophany: a widespread and little-known phenomenon]. / Le vécu subjectif de contact avec un défunt ou nécrophanie : un phénomène répandu et peu connu.

The subjective experience of contact with the deceased (VSCD), spontaneous and direct, by people most often in mourning, is neither rare nor new. It's even considered a universal and timeless phenomenon. Yet this psychological and sensory manifestation, which can manifest itself through sight, hearing, smell or touch, remains little known to the general public and health professionals alike. This article is an opportunity for many to discover this phenomenon, also known as necrophany.

Mental Illness in the 2 Years Prior to Pregnancy in a Population With Traumatic Brain Injury: A Cross-Sectional Study: La maladie mentale dans les deux ans précédant une grossesse dans une population souffrant de lésion cérébrale traumatique : une étude transversale.

OBJECTIVE: Existing studies, in mostly male samples such as veterans and athletes, show a strong association between traumatic brain injury (TBI) and mental illness. Yet, while an understanding of mental health before pregnancy is critical for informing preconception and perinatal supports, there are no data on the prevalence of active mental illness before pregnancy in females with TBI. We examined the prevalence of active mental illness ≤2 years before pregnancy (1) in a population with TBI, and (2) in subgroups defined by sociodemographic, health, and injury-related characteristics, all compared to those without TBI. METHOD: This population-based cross-sectional study was completed in Ontario, Canada, from 2012 to 2020. Modified Poisson regression generated adjusted prevalence ratios (aPRs) of active mental illness ≤2 years before pregnancy in 15,585 females with TBI versus 846,686 without TBI. We then used latent class analysis to identify subgroups with TBI according to sociodemographic, health, and injury-related characteristics and subsequently compared them to females without TBI on their outcome prevalence. RESULTS: Females with TBI had a higher prevalence of active mental illness ≤2 years before pregnancy than those without TBI (44.1% vs. 25.9%; aPR 1.46, 95% confidence interval, 1.43 to 1.49). There were 3 TBI subgroups, with Class 1 (low-income, past assault, recent TBI described as intentional and due to being struck by/against) having the highest outcome prevalence. CONCLUSIONS: Females with TBI, and especially those with a recent intentional TBI, have a high prevalence of mental illness before pregnancy. They may benefit from mental health screening and support in the post-injury, preconception, and perinatal periods. PLAIN LANGUAGE TITLE: Mental illness in the 2 years before pregnancy in a population with traumatic brain injury.

Research has shown a strong association between traumatic brain injury (TBI) and mental illness. Most previous studies have been conducted in primarily male samples, like veterans and professional athletes. Understanding mental health before pregnancy is important for deciding what supports people need before and during pregnancy. However, there are no studies on the frequency of mental illness in females with TBI before a pregnancy. We examined the frequency of mental illness 2 years before pregnancy in a population with TBI, and in subgroups defined by different social, health, and injury-related characteristics, compared to those without TBI. We undertook a population-wide study of all females with and without TBI in Ontario, Canada, with a birth in 2012­2020. We used statistical models to compare these groups on the presence of mental illness in the 2 years before pregnancy, before and after accounting for social and health characteristics. We also identified subgroups with TBI according to their social (e.g., poverty), health (e.g., chronic conditions), and injury-related characteristics (e.g., cause of injury) and subsequently compared them to females without TBI on their frequency of mental illness in the 2 years before pregnancy. Forty-four percent of females with TBI had mental illness in the 2 years before pregnancy compared to 25% of those without TBI. There were 3 TBI subgroups. Females with low-income, past assault, and injuries that were described as being intentional had the highest frequency of mental illness in the 2 years before pregnancy. Females with TBI may benefit from mental health screening and support post-injury and around the time of pregnancy.