Young people are worried about climate change but the association between climate worry and current and past mental health has not been examined in population-based samples.

To examine 1) the prevalence of worry about climate change at age 23-years and its association with contemporaneous mental health symptoms, and 2) and adolescent mental health symptoms.

We used a Canadian population-based birth cohort (n=1325) to examine associations between 1) climate change at age 23-years and concurrent anxiety, depression, and suicidal behaviors, and 2) mental health at age 15 and 17 years defined as anxiety, depression, aggression-opposition, inattention-hyperactivity. We adjusted for participants’ socioeconomic status, childhood IQ, sex, and parental history of psychopathology.

Most participants were worried about climate change: 190 (14.3%) were extremely worried, 553 (41.7%) were somewhat worried, 383 (28.9%) were very worried, and 199 (15.0%) were not at all worried. Worry about climate change was associated with significantly elevated contemporaneous anxiety, depression, and suicidal thoughts. In longitudinal analysis, adolescent anxiety was associated with higher climate change worry at age 23-years while adolescent aggression-opposition was associated with lower climate change worry.

Worry about climate change is associated with contemporaneous mental health symptoms. However, longitudinal analysis suggests that this is largely explained by prior mental health, with adolescent anxiety symptoms linked with higher worry and aggression-opposition with lower worry. Future studies should aim to better define the dimensions of climate anxiety and track it alongside symptoms using prospective follow-up studies.

None Declared

Mental health regional differences during pregnancy through the COVID-19 pandemic is understudied.

We aimed to quantify the impact of the COVID-19 pandemic on maternal mental health during pregnancy.

A cohort study with a web-based recruitment strategy and electronic data collection was initiated in 06/2020. Although Canadian women, >18 years were primarily targeted, pregnant women worldwide were eligible. The current analysis includes data on women enrolled 06/2020-11/2020. Self-reported data included mental health measures (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7)), stress. We compared maternal mental health stratifying on country/continents of residence, and identified determinants of mental health using multivariable regression models.

Of 2,109 pregnant women recruited, 1,932 were from Canada, 48 the United States (US), 73 Europe, 35 Africa, and 21 Asia/Oceania. Mean depressive symptom scores were lower in Canada (EPDS 8.2, SD 5.2) compared to the US (EPDS 10.5, SD 4.8) and Europe (EPDS 10.4, SD 6.5) (p<0.05), regardless of being infected or not. Maternal anxiety, stress, decreased income and access to health care due to the pandemic were increasing maternal depression. The prevalence of severe anxiety was similar across country/continents. Maternal depression, stress, and earlier recruitment during the pandemic (June/July) were associated with increased maternal anxiety.

In this first international study on the impact of the COVID-19 pandemic, CONCEPTION has shown significant country/continent-specific variations in depressive symptoms during pregnancy, whereas severe anxiety was similar regardless of place of residence. Strategies are needed to reduce COVID-19’s mental health burden in pregnancy.

No significant relationships.

Externalising and internalising problems are common in school-aged children. Few studies have examined the association between comorbid externalising and internalising symptoms and adult-life economic participation.

To investigate associations of childhood externalising, internalising, and comorbid internalising-externalising symptoms with earnings and welfare receipt in adulthood.

We used group-based trajectory modeling to identify profiles of children with externalising, internalising, and comorbid symptoms from age 6-12 years. We estimated associations of the identified profiles with participants’ employment earnings at age 33-37 years and welfare receipt from age 18-35 years obtained from tax return records. The child’s IQ and family socioeconomic background were adjusted for.

Four profiles were identified: no symptoms (45%), externalizing (29%), internalizing (11%) and comorbid symptoms (13%). Relative to the no-symptom profile, participants in the comorbid profile earned US$-18,323 less annually (95%CI=-20,925 to -15700) at age 33-37 years and were significantly more likely to receive welfare across follow-up (RR=6.30, 95%CI=5.4 to 7.2). Similarly, compared to the no-symptom profile, participants in the externalising profile earned US$-7,256 less per year (95%CI=-9,205 to -5,307), while participants in the internalising profile earned US$-9,716 less (95%CI=-12,358 to -7,074). Significant interactions by sex were observed. For participants in the comorbid profile, males were more likely to have lower earnings while females were more likely to receive welfare, relative to the no-symptom profile.

Children exhibiting comorbid externalising and internalising symptoms are at high risk of poor economic outcomes in adulthood. Early detection, prevention and management is crucial to improve the life chances of this vulnerable population.

No significant relationships.

Childhood behavioral problems are highly prevalent in school-aged children and are associated with poor long-term outcomes. Yet little is known about their association with patterns of partnering in adulthood.

To (1) describe patterns of partnering from age 18-35 years in a large population-based sample, and (2) examine the association between childhood behavioural problems and adult partnering patterns.

Behavioural ratings were prospectively obtained from teachers when children (n=2960) were aged 10-12 years – for inattention, hyperactivity, aggression-opposition, anxiety and prosociality – and linked to their tax return records from age 18-35 years. We used group-based trajectory modelling to identify distinct trajectories of partnering (married or cohabitating) and multinomial regression models to examine the association between childhood behaviour and trajectory group membership.

Five distinct trajectories of partnering were identified: early-partnered (n=420, 14.4%), mid-partnered (n=620, 21.3%), late-partnered (n=570, 19.2%), early-separated (n=460, 15.5%), and delayed-or-unpartnered (n=890, 30.0%). After adjustment for sex and family background, children rated as being anxious or inattentive were more likely to remain unpartnered from age 18 to 35 years, while those rated as aggressive-oppositional or inattentive were more likely to separate and return to unpartnered status. Prosocial behaviours were consistently associated with earlier and more sustained partnership. Participants in the early-separated and delayed-or-unpartnered trajectories were also more likely to have left high school without a diploma and to have lower earnings.

Childhood behavioural problems were associated with increased likelihood of being unpartnered and of partnership dissolution, which has implications for the psychological health and wellbeing of individuals and their families.

Disruptive behaviours underpin the most prevalent and costly psychiatric disorders in youth including ADHD and conduct disorder. Yet the association between childhood behavioural problems and economic and social outcomes in adulthood are rarely examined in a population-based samples where early detection and prevention may be possible.

To examine the association childhood behavioural problems and economic and social outcomes from age 18-35 years across three studies.

This study daws on 30-year Canadian birth cohort (n=3017) linked to government tax return records. Behavioural assessments – for inattention, hyperactivity, opposition, aggression, anxiety and prosociality – were prospectively obtained from teachers when children were aged 6-12 years. Regression models were used to link behavioural assessments in kindergarten (age 5/6 years) to earnings at age 33-35 years (Study 1) and to trajectories of welfare receipt (Study 2), while behaviour at age 10-12 years was linked to trajectories of partnering. Children’s IQ and family background were adjusted for.

Inattention, aggression-opposition (males only) and low low-prosociality in kindergarten were associated with lower earnings at age 33-35 years (Study 1), inattention, aggression-opposition and low prosociality in kindergarten predicted following a chronic welfare receipt trajectory from age 18-35 (Study 2), and inattention, aggression-opposition, anxiety and low-prosociality at age 10-12 years were associated with increased likelihood of being unpartnered and with partnership dissolution from age 18-35 years (Study3).

Behavioural assessments made by schoolteachers can identify children at risk of adverse economic and social outcomes in adulthood. The implications of for early screening and prevention will be discussed.

No significant relationships.

The thromobolytic drug, tissue plasminogen activator (tPA) has been approved in the United States for the treatment of acute ischemic stroke amid controversy and concern about the balance of risk and benefit. The Canadian Stroke Consortium (CSC), a national network of neurologists who collaborate on joint projects in stroke medicine, including clinical trials and consensus statements, has developed guidelines for the use of tPA in Canada.

The CSC Board of Directors wrote a preliminary report based on existing publications, including randomized drug trials and the report of a special committee struck by the Stroke Council of the American Heart Association. This draft was circulated to the CSC membership-at-large for suggestions or amendments, to produce this final draft.

The present guidelines have been devised to represent a Canadian viewpoint of management. The Health Protection Branch of the Ministry of Health of Canada has not yet produced an evaluation. Further modification of these guidelines may be necessary when more data from clinical trials and experience with the drug become available.

Antisocial personality disorder (ASPD) is characterised by elevated impulsive aggression and increased risk for criminal behaviour and incarceration. Deficient activity of the monoamine oxidase A (MAOA) gene is suggested to contribute to serotonergic system dysregulation strongly associated with impulsive aggression and antisocial criminality.

To elucidate the role of epigenetic processes in altered MAOA expression and serotonin regulation in a population of incarcerated offenders with ASPD compared with a healthy non-incarcerated control population.

Participants were 86 incarcerated participants with ASPD and 73 healthy controls. MAOA promoter methylation was compared between case and control groups. We explored the functional impact of MAOA promoter methylation on gene expression in vitro and blood 5-HT levels in a subset of the case group.

Results suggest that MAOA promoter hypermethylation is associated with ASPD and may contribute to downregulation of MAOA gene expression, as indicated by functional assays in vitro, and regression analysis with whole-blood serotonin levels in offenders with ASPD.

These results are consistent with prior literature suggesting MAOA and serotonergic dysregulation in antisocial populations. Our results offer the first evidence suggesting epigenetic mechanisms may contribute to MAOA dysregulation in antisocial offenders.

The lifetime prevalence of ureterolithiasis is approximately 13% for men and 7% for women in the United States. Tamsulosin, an α-antagonist, has been used as therapy to facilitate the expulsion of lithiasis. Whether it is a good treatment for distal lithiasis remains controversial. We conducted a systematic review and meta-analysis to evaluate the effect of tamsulosin on the passage of distal ureterolithiasis.

A systematic search was conducted using MEDLINE, EMBASE, and Cochrane Central. Trial eligibility was evaluated by two investigators. All randomized controlled trials (RCTs) comparing tamsulosin to standard therapy or placebo for the treatment of a single distal ureterolithiasis ≤ 10 mm in adult patients with renal colic confirmed by radiographic imaging were included. Data extraction was conducted in duplicate. Primary outcome was the expulsion rate, and secondary outcomes were the mean time for ureterolithiasis expulsion, analgesic requirements, and side effects. Mantel-Haenszel random effect models were used, and heterogeneity was assessed using I2 statistics. Data were presented with relative risks (RRs).

The search strategy identified 685 articles, of which 22 studies were included. Combined results suggested a benefit for the expulsion of ureterolithiasis (≥ 10 mm) when tamsulosin was used compared to a standard treatment (RR 1.50 [95% CI 1.31–1.71], I2 = 70%). A decrease in the average time of expulsion of the ureterolithiasis of 3.33 days in favour of tamsulosin was observed (95% CI −4.23, −2.44], I2 = 67%).

Tamsulosin increases the rate of spontaneous passage of distal ureterolithiasis (≤ 10 mm).