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Article ; Online: Antidepressant Effects of Psilocybin in the Absence of Psychedelic Effects.

Rosenblat, Joshua D / Leon-Carlyle, Marisa / Ali, Shaun / Husain, M Ishrat / McIntyre, Roger S

2023 Volume 180, Issue 5, Page(s) 395–396

MeSH term(s)	Humans ; Hallucinogens/pharmacology ; Hallucinogens/therapeutic use ; Psilocybin/pharmacology ; Psilocybin/therapeutic use ; Lysergic Acid Diethylamide ; Antidepressive Agents/pharmacology ; Antidepressive Agents/therapeutic use
Chemical Substances	Hallucinogens ; Psilocybin (2RV7212BP0) ; Lysergic Acid Diethylamide (8NA5SWF92O) ; Antidepressive Agents
Language	English
Publishing date	2023-03-22
Publishing country	United States
Document type	Letter
ZDB-ID	280045-7
ISSN	1535-7228 ; 0002-953X
ISSN (online)	1535-7228
ISSN	0002-953X
DOI	10.1176/appi.ajp.20220835
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Article ; Online: Patient and Therapist Perceptions of a Publicly Funded Internet-Based Cognitive Behavioral Therapy (iCBT) Program for Ontario Adults During the COVID-19 Pandemic: Qualitative Study.

Thapar, Serena / Nguyen, Megan / Khan, Bilal Noreen / Fanaieyan, Roz / Kishimoto, Vanessa / Liu, Rebecca / Bolea-Alamañac, Blanca / Leon-Carlyle, Marisa / O'Riordan, Anne / Keresteci, Maggie / Bhattacharyya, Onil

JMIR formative research

2024 Volume 8, Page(s) e50113

Abstract: Background: To address the anticipated rise in mental health symptoms experienced at the population level during the COVID-19 pandemic, the Ontario government provided 2 therapist-assisted internet-delivered cognitive behavioral therapy (iCBT) programs ... ...

Abstract	Background: To address the anticipated rise in mental health symptoms experienced at the population level during the COVID-19 pandemic, the Ontario government provided 2 therapist-assisted internet-delivered cognitive behavioral therapy (iCBT) programs to adults free of charge at the point of service. Objective: The study aims to explore the facilitators of and barriers to implementing iCBT at the population level in Ontario, Canada, from the perspective of patients and therapists to better understand how therapist-assisted iCBT programs can be effectively implemented at the population level and inform strategies for enhancing service delivery and integration into the health care system. Methods: Using a convenience sampling methodology, semistructured interviews were conducted with 10 therapists who delivered iCBT and 20 patients who received iCBT through either of the publicly funded programs to explore their perspectives of the program. Interview data were analyzed using inductive thematic analysis to generate themes. Results: Six salient themes were identified. Facilitators included the therapist-assisted nature of the program; the ease of registration and the lack of cost; and the feasibility of completing the psychoeducational modules given the online and self-paced nature of the program. Barriers included challenges with the online remote modality for developing the therapeutic alliance; the program's generalized nature, which limited customization to individual needs; and a lack of formal integration between the iCBT program and the health care system. Conclusions: Although the program was generally well-received by patients and therapists due to its accessibility and feasibility, the digital format of the program presented both benefits and unique challenges. Strategies for improving the quality of service delivery include opportunities for synchronous communication between therapists and patients, options for increased customization, and the formal integration of iCBT into a broader stepped-care model that centralizes patient referrals between care providers and promotes continuity of care.
Language	English
Publishing date	2024-02-19
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/50113
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Article ; Online: Assessing Student Attitudes Regarding Cost-Consciousness in Medical Education.

Leon-Carlyle, Marisa / McQuillan, Rory / Baiu, Ioana / Sullivan, Amy / Dukhovny, Dmitry / Shah, Neel

MedEdPublish (2016)

2019 Volume 8, Page(s) 12

Abstract: This article was migrated. The article was marked as recommended. ...

Abstract	This article was migrated. The article was marked as recommended.
Language	English
Publishing date	2019-01-11
Publishing country	Scotland
Document type	Journal Article
ISSN	2312-7996
ISSN (online)	2312-7996
DOI	10.15694/mep.2019.000012.1
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Article ; Online: Choosing wisely Canada: integrating stewardship in medical education.

Leon-Carlyle, Marisa / Srivastava, Raman / Levinson, Wendy

Academic medicine : journal of the Association of American Medical Colleges

2015 Volume 90, Issue 11, Page(s) 1430

MeSH term(s)	Communication ; Consumer Health Information ; Health Services Misuse/prevention & control ; Humans ; Patient Education as Topic ; Patient Participation ; Physician-Patient Relations
Language	English
Publishing date	2015-11
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	96192-9
ISSN	1938-808X ; 1040-2446
ISSN (online)	1938-808X
ISSN	1040-2446
DOI	10.1097/ACM.0000000000000932
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Article ; Online: Psilocybin-assisted psychotherapy for treatment resistant depression: A randomized clinical trial evaluating repeated doses of psilocybin.

Rosenblat, Joshua D / Meshkat, Shakila / Doyle, Zoe / Kaczmarek, Erica / Brudner, Ryan M / Kratiuk, Kevin / Mansur, Rodrigo B / Schulz-Quach, Christian / Sethi, Rickinder / Abate, Amanda / Ali, Shaun / Bawks, Jordan / Blainey, Marc G / Brietzke, Elisa / Cronin, Victoria / Danilewitz, Jessica / Dhawan, Shalini / Di Fonzo, Anthony / Di Fonzo, Melissa /

Drzadzewski, Pawel / Dunlop, William / Fiszter, Hajnalka / Gomes, Fabiano A / Grewal, Smrita / Leon-Carlyle, Marisa / McCallum, Marilyn / Mofidi, Niki / Offman, Hilary / Riva-Cambrin, Jeremy / Schmidt, Joel / Smolkin, Mark / Quinn, Joan M / Zumrova, Andrea / Marlborough, Michelle / McIntyre, Roger S

Med (New York, N.Y.)

2024 Volume 5, Issue 3, Page(s) 190–200.e5

Abstract: Background: Psilocybin-assisted psychotherapy (PAP) has been associated with antidepressant effects. Trials to date have typically excluded participants with complex presentations. Our aim was to determine the feasibility of PAP in a complex population, ...

Abstract	Background: Psilocybin-assisted psychotherapy (PAP) has been associated with antidepressant effects. Trials to date have typically excluded participants with complex presentations. Our aim was to determine the feasibility of PAP in a complex population, including high levels of treatment resistance in major depressive and bipolar disorder and patients with baseline suicidality and significant comorbidity. We also evaluated flexible repeated doses over a 6-month period. Methods: Adults with treatment-resistant depression as part of major depressive or bipolar II disorder without psychosis or a substance use disorder were eligible to participate. Subjects were randomized to immediate treatment or waitlist control, with all eventually receiving PAP. Participants had one, two, or three psilocybin sessions with a fixed dose of 25 mg. Each dose was accompanied by preparation and integration psychotherapy sessions. Acceptability, safety, tolerability, and efficacy were evaluated (this study was registered at ClinicalTrials.gov: NCT05029466). Findings: Participants were randomized to immediate treatment (n = 16) or delayed treatment (n = 14). 29/30 were retained to the week-2 primary endpoint. Adverse events were transient, with no serious adverse events. Greater reductions in depression severity as measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) were observed in the immediate treatment arm compared to the waitlist period arm with a large hedge's g effect size of 1.07 (p < 0.01). Repeated doses were associated with further reductions in MADRS scores compared to baseline. Conclusions: PAP was feasible in complex patients with preliminary antidepressant efficacy and adequate safety and tolerability. Repeated doses were associated with greater reductions in depression severity. Funding: This work was funded by Brain and Cognition Discovery Foundation (BCDF), Usona, and Braxia Scientific.
MeSH term(s)	Adult ; Humans ; Psilocybin/adverse effects ; Depressive Disorder, Major/drug therapy ; Depressive Disorder, Major/chemically induced ; Depressive Disorder, Treatment-Resistant/drug therapy ; Antidepressive Agents/adverse effects ; Psychotherapy
Chemical Substances	Psilocybin (2RV7212BP0) ; Antidepressive Agents
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ISSN	2666-6340
ISSN (online)	2666-6340
DOI	10.1016/j.medj.2024.01.005
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery.

Leon-Carlyle, Marisa / Brown, Jacqueline A / Hamm, Jeremy / Phang, P Terry / Raval, Manoj J / Brown, Carl J

American journal of surgery

2016 Volume 212, Issue 3, Page(s) 455–460

Abstract: Background: Endorectal ultrasound (ERUS) is used to preoperatively assess locoregional stage in patients with rectal neoplasms. This study evaluates the accuracy of ERUS in determining the T stage of rectal neoplasms treated by transanal endoscopic ... ...

Abstract	Background: Endorectal ultrasound (ERUS) is used to preoperatively assess locoregional stage in patients with rectal neoplasms. This study evaluates the accuracy of ERUS in determining the T stage of rectal neoplasms treated by transanal endoscopic microsurgery (TEM). Methods: All patients in the St Paul's Hospital TEM database were evaluated and excluded if they had been treated with neoadjuvant therapy. ERUS results were compared with gold-standard postoperative histopathology reports. Tumor height from anal verge was measured by ERUS and endoscopic techniques. Results: Fifty-three patients were eligible to participate in the study. A Friedman test demonstrated significant difference in the T stage between ERUS and the histopathology reports (P < .001). The tumor height measured by ERUS is significantly higher than the height measured by endoscopy (P < .05). Conclusions: This study confirms that ERUS often overstages rectal neoplasms and suggests that ERUS findings should not preclude TEM in clinically appropriate patients.
MeSH term(s)	Adult ; Aged ; Anal Canal ; Endosonography/methods ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery/methods ; Middle Aged ; Natural Orifice Endoscopic Surgery/methods ; Neoplasm Staging/methods ; Rectal Neoplasms/diagnosis ; Rectum/diagnostic imaging ; Reproducibility of Results ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2016-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2015.10.018
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Article ; Online: Using patient and physician perspectives to develop a shared decision-making framework for colorectal cancer

Gagliardi Anna / Schmocker Selina / Spiegle Gillian / Leon-Carlyle Marisa / Urbach David / Kennedy Erin

Implementation Science, Vol 4, Iss 1, p

2009 Volume 81

Abstract: Abstract Background Colorectal cancer is the third leading cause of death from cancer worldwide with over 900,000 diagnoses and 639,000 deaths each year. Although shared decision making is broadly advocated as a mechanism by which to achieve patient- ... ...

Abstract	Abstract Background Colorectal cancer is the third leading cause of death from cancer worldwide with over 900,000 diagnoses and 639,000 deaths each year. Although shared decision making is broadly advocated as a mechanism by which to achieve patient-centred care, there has been little investigation of patient and physician shared decision-making preferences and practices or the outcomes associated with shared decision making in the context of colorectal cancer. Aim The aim of this study is to determine patient and physician attitudes towards the use of shared decision making in the setting of colorectal cancer. Methods Standard principles of qualitative research will be used to sample and interview 20 colorectal cancer patients in each of three tertiary care hospitals (n = 60) and 15 surgeons, radiation oncologists, and medical oncologists (n = 45) affiliated with cancer centres. The interview questions will be guided by a conceptual framework defining patient and physician factors that influence the shared decision-making process and associated outcomes in the setting of colorectal cancer. An inductive, grounded approach will be used by two investigators to independently analyze the interview transcripts. These investigators will meet to compare and achieve consensus on themes that will be tabulated to compare barriers, enablers, and outcomes of shared decision making by patient, physician, and contextual factors. Discussion This study is the first to examine both patient and physician perspectives on the use of shared decision making for colorectal cancer in North America or elsewhere. It will provide a framework that can be used to describe the shared decision-making process and its outcomes, and evaluate strategies to facilitate this process for patients with colorectal cancer.
Keywords	Medicine (General) ; R5-920
Subject code	006
Language	English
Publishing date	2009-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Using patient and physician perspectives to develop a shared decision-making framework for colorectal cancer.

Leon-Carlyle, Marisa / Spiegle, Gillian / Schmocker, Selina / Gagliardi, Anna / Urbach, David / Kennedy, Erin

Implementation science : IS

2009 Volume 4, Page(s) 81

Abstract: Background: Colorectal cancer is the third leading cause of death from cancer worldwide with over 900,000 diagnoses and 639,000 deaths each year. Although shared decision making is broadly advocated as a mechanism by which to achieve patient-centred ... ...

Abstract	Background: Colorectal cancer is the third leading cause of death from cancer worldwide with over 900,000 diagnoses and 639,000 deaths each year. Although shared decision making is broadly advocated as a mechanism by which to achieve patient-centred care, there has been little investigation of patient and physician shared decision-making preferences and practices or the outcomes associated with shared decision making in the context of colorectal cancer. Aim: The aim of this study is to determine patient and physician attitudes towards the use of shared decision making in the setting of colorectal cancer. Methods: Standard principles of qualitative research will be used to sample and interview 20 colorectal cancer patients in each of three tertiary care hospitals (n = 60) and 15 surgeons, radiation oncologists, and medical oncologists (n = 45) affiliated with cancer centres. The interview questions will be guided by a conceptual framework defining patient and physician factors that influence the shared decision-making process and associated outcomes in the setting of colorectal cancer. An inductive, grounded approach will be used by two investigators to independently analyze the interview transcripts. These investigators will meet to compare and achieve consensus on themes that will be tabulated to compare barriers, enablers, and outcomes of shared decision making by patient, physician, and contextual factors. Discussion: This study is the first to examine both patient and physician perspectives on the use of shared decision making for colorectal cancer in North America or elsewhere. It will provide a framework that can be used to describe the shared decision-making process and its outcomes, and evaluate strategies to facilitate this process for patients with colorectal cancer.
Language	English
Publishing date	2009-12-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2225822-X
ISSN	1748-5908 ; 1748-5908
ISSN (online)	1748-5908
ISSN	1748-5908
DOI	10.1186/1748-5908-4-81
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Article ; Online: Prevalence of Physiologic Sexual Dysfunction Is High Following Treatment for Rectal Cancer: But Is It the Only Thing That Matters?

Leon-Carlyle, Marisa / Schmocker, Selina / Victor, J Charles / Maier, Barbara-Anne / O'Connor, Brenda I / Baxter, Nancy N / McLeod, Robin S / Kennedy, Erin D

Diseases of the colon and rectum

2015 Volume 58, Issue 8, Page(s) 736–742

Abstract: Background: Although several studies have reported high rates of sexual dysfunction in patients treated for rectal cancer, most studies have been limited by retrospective design, failure to use validate instruments, and a limited number of female ... ...

Abstract	Background: Although several studies have reported high rates of sexual dysfunction in patients treated for rectal cancer, most studies have been limited by retrospective design, failure to use validate instruments, and a limited number of female patients. Objectives: The objectives of this study were to 1) prospectively assess changes in sexual function before and after treatment for rectal cancer and 2) identify potential areas for improved care of patients who have rectal cancer with sexual dysfunction. Design: This study is a prospective, longitudinal survey. Settings: This study was conducted at 4 tertiary care academic hospitals. Patients: The patients included had newly diagnosed rectal cancer. Main outcome measures: Subjects completed the European Organization for Research and Treatment Quality of Life Cancer Module and Colorectal Cancer Module, International Index of Erectile Function, and Female Sexual Function Index questionnaires before the start of treatment, after the completion of preoperative chemoradiotherapy, and 1 year after surgery. Results: Forty-five patients completed the study, and the overall results showed significant sexual dysfunction in both male and female subjects that continued to increase from baseline up to 1 year after surgery. In male subjects, sexual activity, interest, and enjoyment remained relatively stable, despite increasing sexual problems. However, for female patients, although sexual activity and interest remained relatively stable, sexual enjoyment worsened as sexual problems increased. Limitations: The study closed before reaching the target sample size owing to lower than anticipated accrual rates. Post hoc analysis included qualitative interviews with patients to explore reasons for low recruitment. Conclusions: The results of this study show that sexual problems continue to increase up to 1 year after surgery. Despite this, sexual interest in both male and female patients remained relatively unchanged suggesting that other aspects of sexuality, not just physiologic function, also need to be evaluated. Future studies to assist and educate physicians on how to initiate a discussion about sexuality and identify patients in "distress" because of sexual problems are important.
MeSH term(s)	Aged ; Chemoradiotherapy ; Cohort Studies ; Digestive System Surgical Procedures ; Disease Progression ; Erectile Dysfunction/epidemiology ; Erectile Dysfunction/physiopathology ; Erectile Dysfunction/psychology ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Neoadjuvant Therapy ; Postoperative Complications/epidemiology ; Postoperative Complications/physiopathology ; Postoperative Complications/psychology ; Prevalence ; Prospective Studies ; Rectal Neoplasms/therapy ; Rectum/surgery ; Sex Factors ; Sexual Dysfunction, Physiological/epidemiology ; Sexual Dysfunction, Physiological/physiopathology ; Sexual Dysfunction, Physiological/psychology ; Surveys and Questionnaires
Language	English
Publishing date	2015-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000000409
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Article ; Online: Development of a synoptic MRI report for primary rectal cancer

Gagliardi Anna R / Milot Laurent / Fruitman Mark / Schmocker Selina / Leon-Carlyle Marisa / Spiegle Gillian / Smith Andy J / McLeod Robin S / Kennedy Erin D

Implementation Science, Vol 4, Iss 1, p

2009 Volume 79

Abstract: Abstract Background Although magnetic resonance imaging (MRI) is an important imaging modality for pre-operative staging and surgical planning of rectal cancer, to date there has been little investigation on the completeness and overall quality of MRI ... ...

Abstract	Abstract Background Although magnetic resonance imaging (MRI) is an important imaging modality for pre-operative staging and surgical planning of rectal cancer, to date there has been little investigation on the completeness and overall quality of MRI reports. This is important because optimal patient care depends on the quality of the MRI report and clear communication of these reports to treating physicians. Previous work has shown that the use of synoptic pathology reports improves the quality of pathology reports and communication between physicians. Methods The aims of this project are to develop a synoptic MRI report for rectal cancer and determine the enablers and barriers toward the implementation of a synoptic MRI report for rectal cancer in the clinical setting. A three-step Delphi process with an expert panel will extract the key criteria for the MRI report to guide pre-operative chemoradiation and surgical planning following a review of the literature, and a synoptic template will be developed. Furthermore, standardized qualitative research methods will be used to conduct interviews with radiologists to determine the enablers and barriers to the implementation and sustainability of the synoptic MRI report in the clinic setting. Conclusion Synoptic MRI reports for rectal cancer are currently not used in North America and may improve the overall quality of MRI report and communication between physicians. This may, in turn, lead to improved patient care and outcomes for rectal cancer patients.
Keywords	Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2009-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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