Psychiatry (Child and Adolescent) - CHEO Research Institute

Mental Health Research at CHEO integrates the three pillars of our mission of high quality clinical care, ground-breaking research, and the education of the next generation of clinical scholars. A number of active research groups exist in psychiatric emergency services, eating disorders, ADHD, pediatric-mental health interface, and knowledge mobilization and outcomes management. Among the research scholars are local, provincial, national, and international leaders of research in child and youth mental health. All of the research enterprises are fully embedded in clinical practice creating the opportunity for the mental health community to be the type of learning environment expected in one of Canada’s leading pediatric teaching hospitals.

Research Projects

Physician Follow-Up of Pediatric and Young Adult Emergency Department Visits for Substance Use in Ontario, Canada
01/11/2024
Association between prenatal air pollutant exposure and autism spectrum disorders in young children: A matched case-control study in Canada
03/08/2024
Associations of neighborhood greenspace, and active living environments with autism spectrum disorders: A matched case-control study in Ontario, Canada
01/07/2024
Components of Outpatient Child and Youth Concurrent Disorders Programs: A Critical Interpretive Synthesis:
09/11/2023

Concurrent disorders, defined as co-occurring mental health and substance use disorders (SUDs), are often underrecognized, undertreated, 1 and lead to significant patient morbidity and mortality, and costs to the healthcare system.2,3 Children and youth aged 15–24 experience the highest rates of mental illness and substance use compared to any other age group, 4 as well as higher rates of concurrent disorders. 5 Previous studies suggest that more than 60% of children and youth with a SUD have a comorbid psychiatric disorder,6,7 such as attention deficit hyperactivity disorder, anxiety disorders, mood disorders, impulse control disorders, or psychotic disorders.7,8 It is estimated that while 15% of adolescents in the general population report symptoms of a substance use problem, less than 1% report receiving treatment in the past year. 9 Moreover, children and youth with concurrent disorders are less likely to access services than those without this comorbidity, due to difficulty connecting with the appropriate services, requirements of abstinence for receipt of services, and exposure to stigmatizing attitudes within the health care system.10,11 The risks of untreated concurrent disorders in young people are well established and include interpersonal difficulties, school drop-out, engagement in risky or illegal activities, hospitalization, and suicide.12-16 In contrast, treatment of concurrent disorders in children and youth has lasting effects and has been shown to reduce mental health and SUD diagnoses and emergency department visits up to three years later. 17
Trends in Rates of Opioid Agonist Treatment and Opioid-Related Deaths for Youths in Ontario, Canada, 2013-2021
06/07/2023

The overdose crisis across North America continues to worsen. While opioid-related deaths concentrate among middle-aged adults, recent data suggests an acceleration in opioid-related mortality among youths.1,2 Opioid agonist treatment (OAT) is a core response to this crisis as it is an evidence-based treatment shown to reduce opioid-related and all-cause mortality among individuals with opioid use disorder (OUD). Despite recommendation for its use,3 there are barriers to accessing OAT among youths, including: stigma, burden of witnessed dosing, and lack of availability of youth-oriented services and prescribers comfortable treating this population.4-6 Given the rising burden of opioid-related mortality in younger demographics, and the known barriers to accessing OAT in this population, we sought to contrast rates of OAT and opioid-related mortality between youths aged 15 and 24 years and adults aged 25 to 44 years in Ontario, Canada.
Pediatric emergency department physicians’ perceptions of virtual mental health assessments for urgent needs
07/02/2023

While many physicians agreed that there is a potential benefit of the ED virtual care platform for urgent mental health assessments, time constraints and lack of confidence in providing satisfactory virtual mental health care with minimal mental health support limited its acceptability. These findings can inform the future implementation of mental health services using an innovative virtual ED platform.
Building Resilience and Attachment in Vulnerable Adolescents: A Pilot Trial of a Brief Group Intervention for Adolescents with Mild to Moderate Suicidal Ideation and their Caregivers
11/11/2022

Study results demonstrate that the BRAVA intervention has the potential to reduce SI among adolescents who present to hospital services in crisis. Further studies are required to establish BRAVA's efficacy in a randomized controlled trial.
Circadian cortisol secretion in adolescent girls with conduct disorder
07/11/2022

This study advanced our knowledge about girls with severe antisocial behavior, discovering that lower circadian cortisol secretion is present in girls with CD, but largely due to decreased volume of cortisol secretion between awakening and 30-minutes post-awakening time. Comorbid internalizing disorders were not associated with differences in circadian secretion of cortisol, compared to girls with only CD.
Peripheral and neural correlates of self-harm in children and adolescents: a scoping review
04/05/2022

Our scoping review demonstrates that this corpus of research is not sufficiently mature for a meta-analysis to identify potential biomarkers. Many conflicting results are reported for the 28 specific correlates. Interpretation of the divergent results is hampered by methods that may have produced biased findings and samples mainly generalizable to clinical populations and girls. Most of the work was done in adolescents, not children younger than 11 years.
Emotional Modulation of Response Inhibition in Adolescents During Acute Suicidal Crisis: Event-Related Potentials in an Emotional Go/NoGo Task
13/12/2021

These findings provide more insight into inhibition difficulties in adolescents with acute suicidal risk. Interactions between emotional and inhibition processing should be considered when treating acutely suicidal youths.
Building Resilience and Attachment in Vulnerable Adolescents (BRAVA): a brief group intervention for adolescents with mild-to-moderate suicidal ideation and their caregivers
08/09/2021

Further studies are required to establish BRAVA’s efficacy in a randomized controlled trial.
Longitudinal association between movement behaviours and depressive symptoms among adolescents using compositional data analysis.
02/09/2021

Isotemporal substitution estimates indicated that decreasing screen time by 60 minutes/day and replacing that time with 60 minutes of additional sleep is associated with the largest change in depressive symptoms across all subgroups.
Implementation and evaluation of a curriculum on the assessment and treatment of disruptive behaviour disorders
03/04/2021

Pre–post-evaluation of the curriculum showed improved knowledge in participants.
Psychological Correlates of Sedentary Screen Time Behaviour Among Children and Adolescents: a Narrative Review
09/12/2020

Practitioners, parents, policy makers and researchers should collectively identify and evaluate strategies to reduce screen time, or to use screens more adaptively, as a means of promoting better mental health among children and adolescents.
What’s the harm in asking? A systematic review and meta-analysis on the risks of asking about suicide-related behaviors and self-harm with quality appraisal
25/07/2020

Unfortunately, misperceptions of harm remain which can compromise clinical care, research, and public health surveillance efforts. Our objective was to evaluate the empirical evidence on whether and how asking about suicide related behaviors (SRB), such as suicidal ideation and suicide attempts, and non-suicidal self-injury (NSSI) results in harmful outcomes.
Medications for sleep disturbance in children and adolescents with depression: a survey of Canadian child and adolescent psychiatrists
01/03/2020

Melatonin and certain off-label psychotropic drugs are perceived as being more effective and appropriate to address sleep disturbances in children and adolescents with depression.
Could long-term administration of melatonin to prepubertal children affect timing of puberty? A clinician’s perspective
31/01/2019

We conclude that to investigate an association between melatonin and pubertal timing, it will be important to conduct long-term randomized controlled trials of latency age children and also examine the cellular and systems-level interactions between melatonin and kisspeptin, a recently identified neuropeptide with a locus of action at the gonadotropin releasing hormone neurons that is important in contributing to the timing of puberty onset.